The Interplay Among Children's Negative Family Representations, Visual Processing of Negative Emotions, and Externalizing Symptoms.

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Davies, Patrick T; Coe, Jesse L; Hentges, Rochelle F; Sturge-Apple, Melissa L; van der Kloet, Erika

2018-03-01

This study examined the transactional interplay among children's negative family representations, visual processing of negative emotions, and externalizing symptoms in a sample of 243 preschool children (M age  = 4.60 years). Children participated in three annual measurement occasions. Cross-lagged autoregressive models were conducted with multimethod, multi-informant data to identify mediational pathways. Consistent with schema-based top-down models, negative family representations were associated with attention to negative faces in an eye-tracking task and their externalizing symptoms. Children's negative representations of family relationships specifically predicted decreases in their attention to negative emotions, which, in turn, was associated with subsequent increases in their externalizing symptoms. Follow-up analyses indicated that the mediational role of diminished attention to negative emotions was particularly pronounced for angry faces. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

Maternal Depression and Youth Internalizing and Externalizing Symptomatology: Severity and Chronicity of Past Maternal Depression and Current Maternal Depressive Symptoms

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O’Connor, Erin E.; Langer, David A.; Tompson, Martha C.

2017-01-01

Maternal depression is a well-documented risk factor for youth depression, and taking into account its severity and chronicity may provide important insight into the degree of risk conferred. This study explored the degree to which the severity/chronicity of maternal depression history explained variance in youth internalizing and externalizing symptoms above and beyond current maternal depressive symptoms among 171 youth (58% male) ages 8 to 12 over a span of three years. Severity and chronicity of past maternal depression and current maternal depressive symptoms were examined as predictors of parent-reported youth internalizing and externalizing symptomatology, as well as youth self-reported depressive symptoms. Severity and chronicity of past maternal depression did not account for additional variance in youth internalizing and externalizing symptoms at Time 1 beyond what was accounted for by maternal depressive symptoms at Time 1. Longitudinal growth curve modeling indicated that prior severity/chronicity of maternal depression predicted levels of youth internalizing and externalizing symptoms at each time point when controlling for current maternal depressive symptoms at each time point. Chronicity of maternal depression, apart from severity, also predicted rate of change in youth externalizing symptoms over time. These findings highlight the importance of screening and assessing for current maternal depressive symptoms, as well as the nature of past depressive episodes. Possible mechanisms underlying the association between severity/chronicity of maternal depression and youth outcomes, such as residual effects from depressive history on mother–child interactions, are discussed. PMID:27401880

Perceived Peer Delinquency and Externalizing Behavior Among Rural Youth: The Role of Descriptive Norms and Internalizing Symptoms.

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Cotter, Katie L; Smokowski, Paul R

2016-03-01

Little research has examined the way in which perceptions of peer behavior (i.e., descriptive norms) influence externalizing behavior among rural adolescents. Using a social norms framework, the current study examined gender differences in the relationship between perceived delinquency among friends and externalizing behavior in a sample of rural adolescents. Based on previous research, the authors proposed that adolescents experience negative emotional responses when they believe that their peers are engaging in delinquency, which subsequently influences externalizing behavior. Consequently, internalizing symptoms were explored as a mediator of the relationship between perceived friend delinquency and externalizing behavior. Data came from the NC-ACE Rural Adaptation Project, a longitudinal panel study of adolescents in two rural, economically disadvantaged counties with exceptional racial/ethnic diversity (29 % White, 25 % African American, 25 % American Indian, 12 % Mixed Race/Other, 9 % Hispanic/Latino). Using multiple group structural equation modeling (N = 3489; 51 % female), results indicated that perceived friend delinquency was significantly related to externalizing behavior and this relationship did not vary by gender. Internalizing symptoms fully mediated the relationship between perceived friend delinquency and externalizing behavior and the path between perceived friend delinquency and internalizing symptoms was stronger for males. Implications of these relationships for prevention and intervention programming for externalizing behavior were highlighted.

Are externalizing and internalizing difficulties of young children with spelling impairment related to their ADHD symptoms?

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Rietz, Chantal Sabrina; Hasselhorn, Marcus; Labuhn, Andju Sara

2012-08-01

Children with literacy difficulties often suffer from a variety of co-occurring externalizing and internalizing difficulties, as well as comorbid ADHD. Therefore, these externalizing and internalizing problems might be more related to comorbid ADHD, rather than being a correlate of literacy difficulties per se. In the present study, we investigated the occurrence of externalizing and internalizing difficulties in elementary school children (third grade) with and without spelling impairment. Taking the high rate of comorbidity between literacy difficulties and ADHD into account, we investigated whether co-occurring difficulties are associated with spelling impairment per se or with comorbid ADHD symptoms. Results indicated that these young children with spelling impairment showed more co-occurring difficulties compared with children without spelling impairment. Hierarchical regression analysis indicated that occurrence of externalizing symptoms is more strongly related to comorbid ADHD symptoms than to spelling impairment per se. The pattern of results concerning internalizing problems was not as distinct but showed a similar trend. Preferably, carers and educators should be aware of co-occurring socio-emotional and behavioural problems in children with spelling impairment. Particularly children with spelling impairment and comorbid ADHD symptoms seem to have an increased risk of encountering further co-occurring difficulties. Copyright © 2012 John Wiley & Sons, Ltd.

Identifying early pathways of risk and resilience: The co-development of internalizing and externalizing symptoms and the role of harsh parenting

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Wiggins, Jillian Lee; Mitchell, Colter; Hyde, Luke W.; Monk, Christopher S.

2015-01-01

Psychological disorders co-occur often in children, but little has been done to document the types of conjoint pathways internalizing and externalizing symptoms may take from the crucial early period of toddlerhood or how harsh parenting may overlap with early symptom co-development. To examine symptom co-development trajectories, we identified latent classes of individuals based on internalizing and externalizing symptoms across ages 3–9 and found three symptom co-development classes: normat...

Correlates of Externalizing Behavior Symptoms among Youth within Two Impoverished, Urban Communities

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Gopalan, Geetha; Cavaleri, Mary A.; Bannon, William M.; McKay, Mary M.

2009-01-01

This study examines whether risk factors associated with child externalizing behavior symptoms differ between two similar low-income, urban communities, using baseline parent data of 154 African American youth (ages 9-15) participating in the Collaborative HIV-Prevention and Adolescent Mental Health Project (CHAMP) family program. Separate…

Impulsive responses to emotion as a transdiagnostic vulnerability to internalizing and externalizing symptoms.

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Johnson, Sheri L; Carver, Charles S; Joormann, Jutta

2013-09-25

This study explored the hypothesis that impulsive reactions to heightened emotion may reflect a transdiagnostic vulnerability to both externalizing and internalizing symptoms. A sample of undergraduates completed self-report measures of aggression, borderline personality disorder symptoms, anxiety symptoms, and alcohol problems, and a subset completed interviews that assessed suicidality. All participants also completed self-report measures relating to impulsivity. We predicted that emotion-reactive impulsivity, but not other aspects of impulsivity, would be related to the set of psychopathology symptoms. Multiple regression analyses found that emotion-reactive impulsivity was uniquely related to each of the psychopathology scales, whereas non-emotion-relevant impulsivity was uniquely related only to alcohol problems. Discussion focuses on limitations and clinical implications. © 2013 Elsevier B.V. All rights reserved.

Parental Depression and Economic Disadvantage: The Role of Parenting in Associations with Internalizing and Externalizing Symptoms in Children and Adolescents.

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Reising, Michelle M; Watson, Kelly H; Hardcastle, Emily J; Merchant, Mary Jane; Roberts, Lorinda; Forehand, Rex; Compas, Bruce E

2013-04-01

This study examined the effects of parental depression symptoms, economic disadvantage, and parenting behaviors in 180 children and adolescents of depressed parents (ages 9-15 years-old). Analyses revealed that while parental depression symptoms, economic disadvantage, and disrupted parenting behaviors were related to children's internalizing and externalizing symptoms, disrupted parenting (e.g., intrusive, neglectful parenting) accounted for the association of parental depressive symptoms and economic disadvantage with children's symptoms. This study provides evidence that disrupted parenting may be a common or shared process through which both parental depression and economic disadvantage are associated with children's internalizing and externalizing problems.

The relationship between attachment styles and internalizing or externalizing symptoms in clinical and nonclinical adolescents

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Fernando Lacasa

2015-05-01

Full Text Available Studies regarding the relationship between attachment and psychopathology during adolescence have been performed separately for clinical and nonclinical adolescents and have used different assessment measures, which together might produce a methodological bias that increases the association between attachment and psychopathology. With the aim of avoiding this bias, the present study used identical measures to explore the relationship between attachment styles and internalizing or externalizing symptoms in clinical and nonclinical samples of adolescents. The sample consisted of 258 adolescents, 129 clinical and 129 nonclinical, aged between 14 and 18 years. The adolescents in each sample were matched for age, gender, and socioeconomic status. Attachment was assessed using the CaMir Q-sort, and psychopathological symptoms were assessed by means of the Youth Self Report (YSR. The relationships between attachment and psychopathology were similar for clinical and nonclinical adolescents. A preoccupied attachment style predicted internalizing and externalizing symptoms, somatic complaints, anxious-fearful behavior, verbal aggression, attention-seeking behavior, and thinking problems. Compared to previous studies, this research has made it possible to identify broader, stronger, and more specific associations between preoccupied attachment style and psychopathological symptoms in adolescents.

The Relations among Maternal Depression, Maternal Criticism, and Adolescents' Externalizing and Internalizing Symptoms.

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Frye, Alice A.; Garber, Judy

2005-01-01

This study examined the relations between maternal criticism and externalizing and internalizing symptoms in adolescents who varied in their risk for psychopathology. Both maternal-effects and child-effects models were examined. The sample consisted of 194 adolescents (mean age = 11.8 years) and their mothers: 146 mothers had a history of…

Externalizing symptoms, effortful control, and intrusive parenting: A test of bidirectional longitudinal relations during early childhood.

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Eisenberg, Nancy; Taylor, Zoe E; Widaman, Keith F; Spinrad, Tracy L

2015-11-01

At approximately 30, 42, and 54 months of age (N = 231), the relations among children's externalizing symptoms, intrusive maternal parenting, and children's effortful control (EC) were examined. Both intrusive parenting and low EC have been related to psychopathology, but children's externalizing problems and low EC might affect the quality of parenting and one another. Mothers' intrusive behavior with their children was assessed with observations, children's EC was measured with mothers' and caregivers' reports, and children's externalizing symptoms were assessed with mothers', fathers', and caregivers' reports. In a structural equation panel model, bidirectional relations between intrusive parenting and EC were found: EC at 30 and 42 months predicted low levels of intrusive parenting a year later, controlling for prior levels of parenting and vice versa. Moreover, high levels of children's externalizing problems at both 30 and 42 months negatively predicted EC a year later, controlling for prior levels of EC. Although externalizing problems positively predicted high EC over time, this appeared to be a suppression effect because these variables had a strong negative pattern in the zero-order correlations. Moreover, when controlling for the stability of intrusive parenting, EC, and externalizing (all exhibited significant stability across time) and the aforementioned cross-lagged predictive paths, EC and externalizing problems were still negatively related within the 54-month assessment. The findings are consistent with the view that children's externalizing behavior undermines their EC and contributes to intrusive mothering and that relations between intrusive parenting and EC are bidirectional across time. Thus, interventions that focus on modifying children's externalizing problems (as well as the quality of parenting) might affect the quality of parenting they receive and, hence, subsequent problems with adjustment.

Parenting and Friendship Quality as Predictors of Internalizing and Externalizing Symptoms in Early Adolescence

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Gaertner, Alden E.; Fite, Paula J.; Colder, Craig R.

2010-01-01

Research indicates both parents and peers influence child and adolescent adjustment outcomes. Moreover, friendship quality has been found to buffer the influence of parenting on adolescent adjustment, particularly externalizing symptoms. Little to no research, however, has longitudinally examined whether friendship quality moderates the relation…

Financial Stress, Parental Depressive Symptoms, Parenting Practices, and Children's Externalizing Problem Behaviors: Underlying Processes

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Lee, Chih-Yuan Steven; Lee, Jaerim; August, Gerald J.

2011-01-01

This study examined the relationships among financial stress encountered by families, parents' social support, parental depressive symptoms, parenting practices, and children's externalizing problem behaviors to advance our understanding of the processes by which family financial stress is associated with children's problem behaviors. We also…

Parametric oesophageal multiple swallow scintigraphy for validation of dysphageal symptoms during external beam irradiation of mediastinal tumours

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Brandt-Mainz, K.; Eising, E.G.; Bockisch, A. [Essen Univ. (Gesamthochschule) (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Mallek, D. von; Poettgen, C.; Stuschke, M.; Sack, H. [Klinik und Poliklinik fuer Strahlentherapie, Universitaetsklinikum Essen (Germany)

2001-03-01

The aim of the study was to evaluate dysphageal symptoms and to measure the effect of local analgesic treatment using parametric oesophageal multiple swallow scintigraphy (PES) during external beam irradiation of the mediastinal region. Fifteen patients (most with lung cancer) with dysphagia grade II underwent PES during external beam radiotherapy of the mediastinum before and after application of local analgesics. Dynamic parametric condensed images were recorded. The intensity of clinical symptoms was correlated with the emptying rate at 10 s (ER-10 s) and the mean transit time (MTT). Visual analysis of the images was performed and the results were correlated with the fields of irradiation portals. Of the 15 patients, 12 showed a correlation between irradiation portals and the region of oesophageal motility disorder. Concordant results of clinical symptoms and PES data were found. In nine patients with a decrease in dysphagia following local analgesia, an increase in mean ER-10 s and a decrease in MTT were observed. In three patients with deterioration in clinical symptoms after analgesic treatment, a similar decrease in mean ER-10 s was found, though MTT remained constant. In three patients with normal values, motility disorders were detected in the dynamic study. In conclusion, PES was found to be a sensitive tool for the validation of dysphageal symptoms in patients during external beam irradiation of mediastinal tumours and for the evaluation and quantification of the efficacy of local analgesic treatment. Additional visual analysis of the dynamic study is helpful in diagnosing minimal disorders. (orig.)

Parametric oesophageal multiple swallow scintigraphy for validation of dysphageal symptoms during external beam irradiation of mediastinal tumours

International Nuclear Information System (INIS)

Brandt-Mainz, K.; Eising, E.G.; Bockisch, A.

2001-01-01

The aim of the study was to evaluate dysphageal symptoms and to measure the effect of local analgesic treatment using parametric oesophageal multiple swallow scintigraphy (PES) during external beam irradiation of the mediastinal region. Fifteen patients (most with lung cancer) with dysphagia grade II underwent PES during external beam radiotherapy of the mediastinum before and after application of local analgesics. Dynamic parametric condensed images were recorded. The intensity of clinical symptoms was correlated with the emptying rate at 10 s (ER-10 s) and the mean transit time (MTT). Visual analysis of the images was performed and the results were correlated with the fields of irradiation portals. Of the 15 patients, 12 showed a correlation between irradiation portals and the region of oesophageal motility disorder. Concordant results of clinical symptoms and PES data were found. In nine patients with a decrease in dysphagia following local analgesia, an increase in mean ER-10 s and a decrease in MTT were observed. In three patients with deterioration in clinical symptoms after analgesic treatment, a similar decrease in mean ER-10 s was found, though MTT remained constant. In three patients with normal values, motility disorders were detected in the dynamic study. In conclusion, PES was found to be a sensitive tool for the validation of dysphageal symptoms in patients during external beam irradiation of mediastinal tumours and for the evaluation and quantification of the efficacy of local analgesic treatment. Additional visual analysis of the dynamic study is helpful in diagnosing minimal disorders. (orig.)

Preventing adolescents’ externalizing and internalizing symptoms: Effects of the Penn Resiliency Program

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J. J. Cutuli

2013-11-01

Full Text Available This study reports secondary outcome analyses from a past study of the Penn Resiliency Program (PRP, a cognitive-behavioral depression prevention program for middle-school aged children. Middle school students (N = 697 were randomly assigned to PRP, PEP (an alternate intervention, or control conditions. Gillham et al., (2007 reported analyses examining PRP’s effects on average and clinical levels of depression symptoms. We examine PRP’s effects on parent-, teacher-, and self-reports of adolescents’ externalizing and broader internalizing (depression/anxiety, somatic complaints, and social withdrawal symptoms over three years of follow-up. Relative to no intervention control, PRP reduced parent-reports of adolescents’ internalizing symptoms beginning at the first assessment after the intervention and persisting for most of the follow-up assessments. PRP also reduced parent-reported conduct problems relative to no-intervention. There was no evidence that the PRP program produced an effect on teacher- or self-report of adolescents’ symptoms. Overall, PRP did not reduce symptoms relative to the alternate intervention, although there is a suggestion of a delayed effect for conduct problems. These findings are discussed with attention to developmental trajectories and the importance of interventions that address common risk factors for diverse forms of negative outcomes.

Reconciling Organisational Culture and External Quality Assurance in Higher Education

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Naidoo, Dhaya

2013-01-01

Organisational culture and external quality assurance have both been presented as significant drivers of effectiveness, efficiency and excellence in higher education institutions. However, these assumptions have not been critically examined given the philosophical, conceptual and methodological contestations surrounding both constructs. A…

Using an Adoption–Biological Family Design to Examine Associations Between Maternal Trauma, Maternal Depressive Symptoms, and Child Internalizing and Externalizing Behaviors

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Grabow, Aleksandria Perez; Khurana, Atika; Natsuaki, Misaki N.; Neiderhiser, Jenae M.; Harold, Gordon T.; Shaw, Daniel S.; Ganiban, Jody M.; Reiss, David; Leve, Leslie D.

2017-01-01

Maternal trauma is a complex risk factor that has been linked to adverse child outcomes, yet the mechanisms underlying this association are not well understood. This study, which included adoptive and biological families, examined the heritable and environmental mechanisms by which maternal trauma and associated depressive symptoms are linked to child internalizing and externalizing behaviors. Path analyses were used to analyze data from 541 adoptive mother–adopted child (AM–AC) dyads and 126 biological mother–biological child (BM–BC) dyads; the two family types were linked through the same biological mother. Rearing mother’s trauma was associated with child internalizing and externalizing behaviors in AM–AC and BM–BC dyads, and this association was mediated by rearing mothers’ depressive symptoms, with the exception of biological child externalizing behavior, for which biological mother trauma had a direct influence only. Significant associations between maternal trauma and child behavior in dyads that share only environment (i.e., AM–AC dyads) suggest an environmental mechanism of influence for maternal trauma. Significant associations were also observed between maternal depressive symptoms and child internalizing and externalizing behavior in dyads that were only genetically related, with no shared environment (i.e., BM–AC dyads), suggesting a heritable pathway of influence via maternal depressive symptoms. PMID:29162177

Parenting Style as a Predictor of Internal and External Behavioural Symptoms in Children : The Child's Perspective

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Hedstrom, Ellen

2016-01-01

The aim of this study was to examine three distinct parenting styles and their effect on children’s behavioural patterns, as perceived by the child. The parenting styles, based on Baumrind’s typologies of authoritative, authoritarian and permissive parenting, were measured as well as the children’s self-rated internal and external symptoms. Results indicated that there was a relationship between authoritarian parenting and all aspects of internal symptoms (depression, loneliness and self-este...

Parental Depression and Economic Disadvantage: The Role of Parenting in Associations with Internalizing and Externalizing Symptoms in Children and Adolescents

OpenAIRE

Reising, Michelle M.; Watson, Kelly H.; Hardcastle, Emily J.; Merchant, Mary Jane; Roberts, Lorinda; Forehand, Rex; Compas, Bruce E.

2013-01-01

This study examined the effects of parental depression symptoms, economic disadvantage, and parenting behaviors in 180 children and adolescents of depressed parents (ages 9–15 years-old). Analyses revealed that while parental depression symptoms, economic disadvantage, and disrupted parenting behaviors were related to children’s internalizing and externalizing symptoms, disrupted parenting (e.g., intrusive, neglectful parenting) accounted for the association of parental depressive symptoms an...

The Effect of External Apple Vinegar Application on Varicosity Symptoms, Pain, and Social Appearance Anxiety: A Randomized Controlled Trial

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Derya Atik

2016-01-01

Full Text Available Aim. We aimed to determine the effect of external apple vinegar application on the symptoms and social appearance anxiety of varicosity patients who were suggested conservative treatment. Method. The study was planned as an experimental, randomized, and controlled study. 120 patients were randomly selected and then were randomly allocated to either experimental or control group by simple blind random sampling method. In the collection of research data, a questionnaire questioning sociodemographic and clinical characteristics, the Visual Analog Scale (VAS for pain, and the Social Appearance Anxiety Scale (SAAS were used. The patients in the study group were suggested to apply apple vinegar to the area of the leg with varicosity alongside the treatment suggested by the doctor. The patients in the control group received no intervention during the study. Results. The sociodemographic and clinic characteristics of both groups were found to be similar (p>0.05. The patients were evaluated with regard to cramps, pain, leg fatigue perception, edema, itching, pigmentation, and weight feelings in the leg, VAS, and SAAS averages in the second evaluation; the control group had a decrease in such symptoms (p>0.05 although the decrease in the application group was higher and statistically meaningful (p<0.05. Conclusion. We determined that the external application of apple vinegar on varicosity patients, which is a very easy application, increased the positive effects of conservative treatment.

External Stakeholders of Higher Education Institutions in Poland: Their Identification and Significance

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Piotrowska-Piatek, Agnieszka

2017-01-01

In the context of the ongoing changes in the management systems of higher education, the issue of higher education institutions' (HEIs) relationships with external stakeholders are of key importance. This article discusses this problem from the perspective of Polish higher education system. The aim of it is to answer the following questions: (1)…

The Effects of Parental Depressive Symptoms, Appraisals, and Physical Punishment on Later Child Externalizing Behavior

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Callender, Kevin A.; Olson, Sheryl L.; Choe, Daniel E.; Sameroff, Arnold J.

2012-01-01

Examined a cognitive-behavioral pathway by which depressive symptoms in mothers and fathers increase risk for later child externalizing problem behavior via parents' appraisals of child behavior and physical discipline. Participants were 245 children (118 girls) at risk for school-age conduct problems, and their parents and teachers. Children were…

Family Conflict, Mood, and Adolescents’ Daily School Problems: Moderating Roles of Internalizing and Externalizing Symptoms

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Timmons, Adela C.; Margolin, Gayla

2014-01-01

Using daily diary data, this study examined cross-day associations between family conflict and school problems and tested mediating effects of daily negative mood and moderating effects of psychological symptoms. For 2 weeks, parents and adolescents (N = 106; mean age = 15.4) reported daily conflict; adolescents reported daily negative mood and school problems. Results indicated bidirectional, multi-day spillover between parent-adolescent conflict and school problems with daily negative mood statistically accounting for spillover both within and across days. Externalizing symptoms strengthened links between father-adolescent conflict and school problems, whereas depressive and anxious symptoms strengthened links between parent-adolescent conflict and daily negative mood. By demonstrating cross-domain transmission of daily problems, these findings highlight the salience of everyday events as possible intervention targets. PMID:25346538

Higher Education Quality: Perception Differences among Internal and External Stakeholders

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Abidin, Munirul

2015-01-01

Conceptually, education quality of higher education can be determined by evaluation of their stakeholders's satisfaction level. The purpose of this study is to describe how students as external stakeholder and lecturers as internal stakeholder, perceived their satisfaction of learning experience in the university. This study was conducted in…

The Association of Maternal Depressive Symptoms with Child Externalizing Problems: The Role of Maternal Support Following Child Sexual Abuse

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Rakow, Aaron; Smith, Daniel; Begle, Angela M.; Ayer, Lynsay

2011-01-01

This study examines the role of abuse-specific maternal support in the association between parent depressive symptoms and child externalizing problems in a sample of children with a history of sexual abuse. In total, 106 mother-child dyads were studied. The association between maternal depressive symptoms and child delinquency behaviors was found…

The interaction between parenting and children's cortisol reactivity at age 3 predicts increases in children's internalizing and externalizing symptoms at age 6.

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Barrios, Chelsey S; Bufferd, Sara J; Klein, Daniel N; Dougherty, Lea R

2017-10-01

Little is known about the role of stress reactivity in the emergence of psychopathology across early childhood. In this longitudinal study, we tested the hypothesis that child cortisol reactivity at age 3 moderates associations between early parenting and children's internalizing and externalizing symptoms from age 3 to age 6. One hundred and sixty children were assessed at age 3, and 135 children were reassessed at age 6. At age 3, we exposed children to stress-inducing laboratory tasks, during which we obtained four salivary cortisol samples, and parental hostility was assessed using an observational parent-child interaction task. At ages 3 and 6, child psychiatric symptoms were assessed using a clinical interview with parents. The results indicated that the combination of high child cortisol reactivity and high observed parental hostility at age 3 was associated with greater concurrent externalizing symptoms at age 3 and predicted increases in internalizing and externalizing symptoms from age 3 to age 6. Findings highlight that increased stress reactivity, within the context of hostile parenting, plays a role in the emergence of psychopathology from preschool to school entry.

Trance, Transparency and Transformation: The Impact of External Quality Monitoring on Higher Education.

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Stensaker, Bjorn

2003-01-01

Discusses the impact of external quality monitoring (EQM) on higher education and identifies areas in which changes have taken place as a result of such external initiatives. Suggests that the lack of effects related directly to quality improvement should not be conceived as an EQM design error, but rather as a misconception of how organizational…

Mediators of the Associations between Externalizing Behaviors and Internalizing Symptoms in Late Childhood and Early Adolescence

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Yong, Minglee; Fleming, Charles B.; McCarty, Carolyn A.; Catalano, Richard F.

2014-01-01

This study tests the predictive associations between externalizing behaviors and internalizing symptoms and examines the mediating roles of social competence, parent-child conflicts, and academic achievement. Using youth-, parent-, and teacher-reported longitudinal data on a sample of 523 boys and 460 girls from late childhood to early…

Family conflict, mood, and adolescents' daily school problems: moderating roles of internalizing and externalizing symptoms.

Science.gov (United States)

Timmons, Adela C; Margolin, Gayla

2015-01-01

Using daily diary data, this study examined cross-day associations between family conflict and school problems and tested mediating effects of daily negative mood and moderating effects of psychological symptoms. For 2 weeks, parents and adolescents (N = 106; Mage = 15.4) reported daily conflict; adolescents reported daily negative mood and school problems. Results indicated bidirectional, multiday spillover between parent-adolescent conflict and school problems with daily negative mood statistically accounting for spillover both within and across days. Externalizing symptoms strengthened links between father-adolescent conflict and school problems, whereas depressive and anxious symptoms strengthened links between parent-adolescent conflict and daily negative mood. By demonstrating cross-domain transmission of daily problems, these findings highlight the salience of everyday events as possible intervention targets. © 2014 The Authors. Child Development © 2014 Society for Research in Child Development, Inc.

Efficacy of Parent Management Training on Reducing Symptoms of External Disturbances in Children with Attention Deficit/Hyperactivity

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S. Arabi

2013-08-01

Full Text Available Background: The objective of this study was to determine the effectiveness of the group program "parent management training" to reduce the symptoms of external disorders of children affected by attention deficit/hyperactivity disorder (ADHD. Methods: The method was semi-experimental design with pretest, posttest, control group, and follow-up was two months. Statistical population were all parents of children with ADHD in the Alborz province, who had referred from 2010 to clinic of childhood and adolescence disorders’ Dr. Maryam Dalili, and had records there. Among them 30 children aged 3-10 and their parents were selected by sampling and matched with regard to research criteria and were randomly divided into two groups of 15 people. Research tool was Rutter`s behavioral assessment questionnaire 1964 that was performed in both groups in pretest, posttest and follow-up. The Management training program for parents of Barkely 1987, included 9 session one-hour, once a week was presented to parents of experimental group, and the control group received no intervention. Data were analyzed by using one-way intra group covariance analysis. Results: Results showed that parents management training significantly has reduced the behavioral disorders symptoms and external signs including aggression, impulsivity, hyperactivity and anxiety in children with ADHA compared with the control group and pretest stage. Conclusion: Parent management training can be an effective method to treat the external symptoms of children with ADHA, and this method can be used in combination with other treatments that are performed about these children, such as drug therapy, behavioral therapy and so on.

Dimensional structure of DSM-5 posttraumatic stress symptoms: support for a hybrid Anhedonia and Externalizing Behaviors model.

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Armour, Cherie; Tsai, Jack; Durham, Tory A; Charak, Ruby; Biehn, Tracey L; Elhai, Jon D; Pietrzak, Robert H

2015-02-01

Several revisions to the symptom clusters of posttraumatic stress disorder (PTSD) have been made in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Central to the focus of this study was the revision of PTSD's tripartite structure in DSM-IV into four symptom clusters in DSM-5. Emerging confirmatory factor analytic (CFA) studies have suggested that DSM-5 PTSD symptoms may be best represented by one of two 6-factor models: (1) an Externalizing Behaviors model characterized by a factor which combines the irritability/anger and self-destructive/reckless behavior items; and (2) an Anhedonia model characterized by items of loss of interest, detachment, and restricted affect. The current study conducted CFAs of DSM-5 PTSD symptoms assessed using the PTSD Checklist for DSM-5 (PCL-5) in two independent and diverse trauma-exposed samples of a nationally representative sample of 1484 U.S. veterans and a sample of 497 Midwestern U.S. university undergraduate students. Relative fits of the DSM-5 model, the DSM-5 Dysphoria model, the DSM-5 Dysphoric Arousal model, the two 6-factor models, and a newly proposed 7-factor Hybrid model, which consolidates the two 6-factor models, were evaluated. Results revealed that, in both samples, both 6-factor models provided significantly better fit than the 4-factor DSM-5 model, the DSM-5 Dysphoria model and the DSM-5 Dysphoric Arousal model. Further, the 7-factor Hybrid model, which incorporates key features of both 6-factor models and is comprised of re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptom clusters, provided superior fit to the data in both samples. Results are discussed in light of theoretical and empirical support for the latent structure of DSM-5 PTSD symptoms. Copyright © 2014 Elsevier Ltd. All rights reserved.

Neural Reactivity to Emotional Stimuli Prospectively Predicts the Impact of a Natural Disaster on Psychiatric Symptoms in Children.

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Kujawa, Autumn; Hajcak, Greg; Danzig, Allison P; Black, Sarah R; Bromet, Evelyn J; Carlson, Gabrielle A; Kotov, Roman; Klein, Daniel N

2016-09-01

Natural disasters expose entire communities to stress and trauma, leading to increased risk for psychiatric symptoms. Yet, the majority of exposed individuals are resilient, highlighting the importance of identifying underlying factors that contribute to outcomes. The current study was part of a larger prospective study of children in Long Island, New York (n = 260). At age 9, children viewed unpleasant and pleasant images while the late positive potential (LPP), an event-related potential component that reflects sustained attention toward salient information, was measured. Following the event-related potential assessment, Hurricane Sandy, the second costliest hurricane in United States history, hit the region. Eight weeks after the hurricane, mothers reported on exposure to hurricane-related stress and children's internalizing and externalizing symptoms. Symptoms were reassessed 8 months after the hurricane. The LPP predicted both internalizing and externalizing symptoms after accounting for prehurricane symptomatology and interacted with stress to predict externalizing symptoms. Among children exposed to higher levels of hurricane-related stress, enhanced neural reactivity to unpleasant images predicted greater externalizing symptoms 8 weeks after the disaster, while greater neural reactivity to pleasant images predicted lower externalizing symptoms. Moreover, interactions between the LPP and stress continued to predict externalizing symptoms 8 months after the hurricane. Results indicate that heightened neural reactivity and attention toward unpleasant information, as measured by the LPP, predispose children to psychiatric symptoms when exposed to higher levels of stress related to natural disasters, while greater reactivity to and processing of pleasant information may be a protective factor. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

The Role of Parents' Attachment Orientations, Depressive Symptoms, and Conflict Behaviors in Children's Externalizing and Internalizing Behavior Problems

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Marchand, Jennifer F.; Schedler, Steven; Wagstaff, David A.

2004-01-01

The present study examined links among parents' attachment orientations, depressive symptoms, and conflict behaviors (attacking and compromising) and children's externalizing and internalizing behavior problems in a sample of 64 nonclinical, Caucasian families. Correlational analyses showed that all three parent attributes were significantly…

Masculine Traits and Depressive Symptoms in Older and Younger Men and Women.

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Price, Elizabeth C; Gregg, Jeffrey J; Smith, Merideth D; Fiske, Amy

2018-01-01

Evidence suggests that men who strongly endorse masculine traits display an atypical presentation of depression, including more externalizing symptoms (e.g., anger or substance use), but fewer typical, internalizing symptoms (e.g., depressed mood or crying). This phenomenon has not been adequately explored in older adults or women. The current study used the externalizing subscale of the Masculine Depression Scale in older and younger men and women to detect atypical symptoms. It was predicted that individuals who more strongly endorsed masculine traits would have higher scores on the measure of externalizing symptoms relative to a measure of typical depressive symptoms Center for Epidemiologic Studies-Depression Scale. It was anticipated that results would differ by age-group but not by gender. Multigroup path analysis was used to test the hypothesis. The hypothesized path model, in which endorsement of masculine traits was associated with lower scores on the Center for Epidemiologic Studies-Depression Scale and with scores on the externalizing, but not internalizing, factor of the Masculine Depression Scale, fit the data well. Results differed significantly by age-group and gender. Masculine individuals reported lower levels of typical depressive symptoms relative to externalizing symptoms, but further research is needed within age- and gender groups. Results are consistent with the gendered responding framework and suggest that current assessment tools, which tend to focus on internalizing symptoms of depression, may not detect depression in individuals who endorse masculine traits.

The Association Between Prenatal Stress and Externalizing Symptoms in Childhood: Evidence From the Avon Longitudinal Study of Parents and Children.

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MacKinnon, Nathalie; Kingsbury, Mila; Mahedy, Liam; Evans, Jonathan; Colman, Ian

2018-01-15

It has been suggested that prenatal maternal stress may increase the risk of childhood externalizing disorders, yet no large cohort study has investigated this association across a large range of acute stressors. Our objective was to estimate the association between prenatal stressful events and risk of offspring conduct disorder and hyperactivity. We used data from 10,184 mother-offspring pairs from the United Kingdom-based Avon Longitudinal Study of Parents and Children. Mothers self-reported 42 prenatal stressful life events at 18 weeks' gestation. Symptoms of conduct disorder and hyperactivity in their offspring were measured at 6, 9, 11, 13, and 16 years of age using the Strengths and Difficulties Questionnaire. The primary outcome was membership in high-symptom trajectories of 1) conduct disorder and 2) hyperactivity throughout childhood, identified using latent class growth modeling. Multinomial logistic regression models estimated the association between prenatal stress and both conduct disorder and hyperactivity, after adjusting for sex, parental education, low birth weight, preterm birth, parental social class, maternal smoking and drinking, maternal mental health, offspring stressful life events, and offspring depressive and anxious symptoms. Those exposed to the highest quartile of prenatal stress were more likely to belong to the high symptom trajectory for hyperactivity (B = 0.46, p < .05) and conduct disorder (B = 0.88, p < .01), respectively. Prenatal stress further demonstrated a positive, dose-response relationship with symptoms of externalizing disorders at independent time points. The findings suggest that prenatal stressful events may be an independent risk factor for offspring externalizing symptoms, regardless of maternal mental health and offspring internalizing. Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Internal versus External Auditory Hallucinations in Schizophrenia: Symptom and Course Correlates

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Docherty, Nancy M.; Dinzeo, Thomas J.; McCleery, Amanda; Bell, Emily K.; Shakeel, Mohammed K.; Moe, Aubrey

2015-01-01

Introduction The auditory hallucinations associated with schizophrenia are phenomenologically diverse. “External” hallucinations classically have been considered to reflect more severe psychopathology than “internal” hallucinations, but empirical support has been equivocal. Methods We examined associations of “internal” v. “external” hallucinations with (a) other characteristics of the hallucinations, (b) severity of other symptoms, and (c) course of illness variables, in a sample of 97 stable outpatients with schizophrenia or schizoaffective disorder who experienced auditory hallucinations. Results Patients with internal hallucinations did not differ from those with external hallucinations on severity of other symptoms. However, they reported their hallucinations to be more emotionally negative, distressing, and long-lasting, less controllable, and less likely to remit over time. They also were more likely to experience voices commenting, conversing, or commanding. However, they also were more likely to have insight into the self-generated nature of their voices. Patients with internal hallucinations were not older, but had a later age of illness onset. Conclusions Differences in characteristics of auditory hallucinations are associated with differences in other characteristics of the disorder, and hence may be relevant to identifying subgroups of patients that are more homogeneous with respect to their underlying disease processes. PMID:25530157

Dynamical symmetry restoration for a higher-derivative four-fermion model in an external electromagnetic field

International Nuclear Information System (INIS)

Elizalde, E.; Gavrilov, S.P.; Shil'nov, Yu.I.

2000-01-01

A four-fermion model with additional higher-derivative terms is investigated in an external electromagnetic field. The effective potential in the leading order of large-N expansion is calculated in external constant magnetic and electric fields. It is shown that, in contrast to the former results concerning the universal character of 'magnetic catalysis' in dynamical symmetry breaking, in the present higher-derivative model the magnetic field restores chiral symmetry broken initially on the tree level. Numerical results describing a second-order phase transition that accompanies the symmetry restoration at the quantum level are presented. (author)

Executive Functioning, Cortisol Reactivity, and Symptoms of Psychopathology in Girls with Premature Adrenarche

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Sontag-Padilla, Lisa M.; Dorn, Lorah D.; Tissot, Abbigail; Susman, Elizabeth J.; Beers, Sue R.; Rose, Susan R.

2012-01-01

The study examined the interaction between early maturational timing [as measured by premature adrenarche (PA)] and executive functioning and cortisol reactivity on symptoms of psychopathology. The study included 76 girls aged 6 through 8 years (mean = 7.50; SD = .85) with PA (n = 40) and on-time adrenarche (n = 36). Girls completed a battery of psychological and neuropsychological tests and blood sampling for cortisol. Parents completed the Child Behavior Checklist. Results demonstrated that girls with PA with lower levels of executive functioning had higher externalizing and anxious symptoms compared to other girls. Additionally, girls with PA who demonstrated increases in serum cortisol had higher externalizing symptoms than those with stable patterns. Finally, girls with PA who demonstrated decreases in cortisol reported higher depressive symptoms. Findings from this study provide important information concerning the impact of cognitive functioning and stress reactivity on adjustment to early maturation in girls with PA. Results of this research may inform screening and intervention efforts for girls who may be at greatest risk for emotional and behavioral problems as a result of early maturation. PMID:22293005

The effects of recurrent physical abuse on the co-development of behavior problems and posttraumatic stress symptoms among child welfare-involved youth.

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Yoon, Susan; Barnhart, Sheila; Cage, Jamie

2018-04-27

The primary aim of the current study was to examine the longitudinal effects of ongoing physical abuse on the co-development of externalizing behavior problems and posttraumatic stress (PTS) symptoms among child welfare-involved adolescents. Using three waves of data from the National Survey of Child and Adolescent Well-Being, we performed unconditional and conditional parallel process latent growth curve modeling in a structural equation modeling framework. The study sample included 491 adolescents who were between 11 and 13 years of age at baseline. Higher levels of initial PTS symptoms were associated with higher levels of externalizing behavior problems, but the rate of change in PTS symptoms were not significantly associated with the rate of change in externalizing behavior problems over time. Although physical abuse was concurrently associated with both externalizing behavior problems and PTS symptoms at all assessment points, there were no lagged effects. Additionally, we found that physical abuse indirectly affects subsequent development of externalizing behavior problems and PTS symptoms through ongoing physical abuse. Findings highlight the comorbidity of externalizing behaviors and PTS symptoms among early adolescents in the child welfare system, underlining the importance of screening for and addressing these problems simultaneously. Findings also point to the need for continued assessment of and protection from ongoing physical abuse during adolescence. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effects of Decreasing External Incentives on Higher Education--Reflections from the Case of Taiwan

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Lin, Yung-feng

2016-01-01

Widened participation in post-compulsory and higher education is generally regarded as a result of the growing recognition of the internal and external benefits of higher education, which are categorised either as a private or public good. However, a question can be raised: once these incentives become less promising or less evident, will a strong…

Higher Medical Morbidity Burden is Associated with External Locus of Control

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Henninger, Debra E.; Whitson, Heather E.; Cohen, Harvey J.; Ariely, Dan

2012-01-01

OBJECTIVES Locus of control (LOC) is a psychological construct reflecting the degree to which one perceives circumstances to be controlled by personal actions (internal LOC) versus outside factors (external LOC). Because LOC could influence a patient's medical decision-making and health behaviors, our objective is to describe the association between an increasing number of co-existing conditions and LOC in older adults. DESIGN Cross-sectional study using survey data from the North Carolina Established Population for Epidemiologic Studies of the Elderly (NC EPESE) dataset. SETTING and PARTICIPANTS Community-dwelling older adults aged 68 and older (N=3,212). MEASUREMENTS Nine common medical conditions were assessed by self-report. LOC was measured by standard questionnaire. Analyses adjusted for demographics, functional status (self-reported activities of daily living), cognition (Short Portable Mental Status Questionnaire), and depression score (Center for Epidemiologic Studies Depression Scale). RESULTS A higher number of chronic conditions was associated with external LOC (β=0.37, p<0.001). This relationship persisted after adjustment for age, race, sex, functional status, cognition, and depression (β=0.17, p <0.0001). Most individual conditions were not associated with LOC, although vision impairment (p<0.001) and arthritis (p<0.05) were associated with more internal LOC. CONCLUSION These results suggest that medically complex patients tend to exhibit a more external LOC, meaning that they perceive little personal control over circumstances and environment. Clinicians should be aware of this tendency, as external LOC may impede an older adult's willingness to engage in the considerable task of managing multiple chronic conditions. PMID:22458257

Factors associated with higher levels of depressive symptoms among international university students in the Philippines.

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Lee, Romeo B; Maria, Madelene Sta; Estanislao, Susana; Rodriguez, Cristina

2013-11-01

Over the years, the number of international university students has been increasing in the Philippines. Depression tends to be common among this demographic sector, because of the varying challenges and expectations associated with studying abroad. Depression can be prevented if its symptoms, particularly those at higher levels, are identified and addressed early and effectively. This survey examined the social and demographic factors that are significantly associated with higher levels of depressive symptoms. One hundred twenty-six international university students were interviewed using the University Students Depression Inventory. Of the 13 factors analyzed, 3 were found with statistically significant associations with more intense levels of depressive symptoms. These factors were: level of satisfaction with one's financial condition, level of closeness with parents, and level of closeness with peers. In identifying international students with greater risk for depression, characteristics related to their financial condition and primary group relationships can be considered. There is a need to carry out more studies to confirm this initial evidence. The findings can help guide further discourse, research and program to benefit international students with higher levels of depressive symptoms.

Attachment to God/Higher Power and Bulimic Symptoms among College Women

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Buser, Juleen K.; Gibson, Sandy

2016-01-01

The authors examined the relationship between avoidant and anxious attachment to God/Higher Power and bulimia symptoms among 599 female college student participants. After controlling for body mass index, the authors found a positive association between both attachment variables and bulimia. When entered together in a regression, anxious…

Testing the adaptation to poverty-related stress model: predicting psychopathology symptoms in families facing economic hardship.

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Wadsworth, Martha E; Raviv, Tali; Santiago, Catherine Decarlo; Etter, Erica M

2011-01-01

This study tested the Adaptation to Poverty-related Stress Model and its proposed relations between poverty-related stress, effortful and involuntary stress responses, and symptoms of psychopathology in an ethnically diverse sample of low-income children and their parents. Prospective Hierarchical Linear Modeling analyses conducted with 98 families (300 family members: 136 adults, 82 adolescents and preadolescents, 82 school-age children) revealed that, consistent with the model, primary and secondary control coping were protective against poverty-related stress primarily for internalizing symptoms. Conversely, disengagement coping exacerbated externalizing symptoms over time. In addition, involuntary engagement stress responses exacerbated the effects of poverty-related stress for internalizing symptoms, whereas involuntary disengagement responses exacerbated externalizing symptoms. Age and gender effects were found in most models, reflecting more symptoms of both types for parents than children and higher levels of internalizing symptoms for girls.

Symptoms of internalizing and externalizing problems: modeling recovery curves after the death of a parent.

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Schmiege, Sarah J; Khoo, Siek Toon; Sandler, Irwin N; Ayers, Tim S; Wolchik, Sharlene A

2006-12-01

The death of a parent is a major family disruption that can place children at risk for later depression and other mental health problems. Theoretically based randomized controlled trial for parentally bereaved children. Two-hundred and forty-four children and adolescents and their caregivers from 156 families were randomly assigned to the Family Bereavement Program (FBP) intervention condition (90 families; 135 children) or to a control condition (66 families; 109 children). Data collection occurred from 1996 to 1998. Children and caregivers in the intervention condition met separately for 12 two-hour weekly sessions. Skills targeted by the program for children included positive coping, stress appraisals, control beliefs, and self-esteem. The caregiver program targeted caregiver mental health, life stressors, and improved discipline in the home. Both child and caregiver programs focused on improved quality of the caregiver-child relationship. Child and caregiver reports of internalizing and externalizing symptoms. Longitudinal growth curve modeling was performed to model symptoms over time from the point of parental death. The rate of recovery for girls in the program condition was significantly different from that of girls in the control condition across all outcomes. Boys in both conditions showed reduced symptoms over time. The methodology offers a conceptually unique way of assessing recovery in terms of reduced mental health problems over time after an event and has contributed to further understanding of FBP intervention effects. The intervention program facilitated recovery among girls, who did not show reduction in behavior problems without the program, while boys demonstrated decreased symptoms even without intervention.

Shame and Alienation Related to Child Maltreatment: Links to Symptoms Across Generations.

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Babcock Fenerci, Rebecca L; DePrince, Anne P

2017-11-20

The current study investigated associations between appraisals of shame and alienation related to mothers' own experiences of child maltreatment and symptoms across generations-in mothers themselves as well as their toddler/preschool-aged children. Mothers who survived maltreatment (N = 113) with a child between the ages of 2 and 5 were recruited to participate in an online study on Maternal Coping, Attachment and Health. Mother participants completed a series of questionnaires, including those that asked about posttrauma appraisals of their own maltreatment experiences as well as their child's and their own mental health symptoms. When taking into account other posttrauma appraisals (e.g., fear, betrayal, anger, self-blame), maternal shame and alienation were both significantly associated with maternal trauma-related distress (a composite of anxiety, PTSD, dissociation, and depressive symptoms). Maternal shame was also significantly linked to child internalizing symptoms and externalizing symptoms. Lower levels of fear and higher levels of betrayal were associated with externalizing symptoms as well. Maternal trauma-related distress mediated the relationship between maternal shame and child externalizing symptoms, and partially mediated the relationship between shame and internalizing symptoms. This study is the first of its kind to examine the role of posttrauma appraisals among mother survivors of maltreatment as they relate to symptoms in their young children. Although additional research is necessary, findings suggest that mothers' posttrauma appraisals, such as shame, could be a relevant factor in the early social-emotional development of survivors' children. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Self-injury and externalizing pathology: a systematic literature review.

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Meszaros, Gergely; Horvath, Lili Olga; Balazs, Judit

2017-05-03

During the last decade there is a growing scientific interest in nonsuicidal self-injury (NSSI). The aim of the current paper was to review systematically the literature with a special focus on the associations between self-injurious behaviours and externalizing psychopathology. An additional aim was to review terminology and measurements of self-injurious behaviour and the connection between self-injurious behaviours and suicide in the included publications. A systematic literature search was conducted on 31st December 2016 in five databases (PubMed, OVID Medline, OVID PsycINFO, Scopus, Web of Science) with two categories of search terms (1. nonsuicidal self-injury, non-suicidal self-injury, NSSI, self-injurious behaviour, SIB, deliberate self-harm, DSH, self-injury; 2. externalizing disorder, attention deficit hyperactivity disorder, ADHD, conduct disorder, CD, oppositional defiant disorder, OD, ODD). Finally 35 papers were included. Eleven different terms were found for describing self-injurious behaviours and 20 methods for measuring it. NSSI has the clearest definition. All the examined externalizing psychopathologies had strong associations with self-injurious behaviours according to: higher prevalence rates in externalizing groups than in control groups, higher externalizing scores on the externalizing scales of questionnaires, higher symptom severity in self-injurious groups. Eight studies investigated the relationship between suicide and self-injurious behaviours and found high overlap between the two phenomena and similar risk factors. Based on the current findings the association between externalizing psychopathology and self-injurious behaviours has been proven by the scientific literature. Similarly to other reviews on self-injurious behaviours the confusion in terminology and methodology was noticed. NSSI is suggested for use as a distinct term. Further studies should investigate the role of comorbid conditions in NSSI, especially when internalizing

Pubertal Timing and Mexican-Origin Girls’ Internalizing and Externalizing Symptoms: The Influence of Harsh Parenting

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Deardorff, J.; Cham, H.; Gonzales, NA.; White, R.M.B.; Tein, J.-Y.; Wong, J.; Roosa, M.W.

2012-01-01

Early-maturing girls are at risk for internalizing and externalizing problems. Scarce research has examined pubertal timing and mental health among Mexican Americans, or examined the influence of parenting behaviors on these relations. This study addressed these gaps. This was a prospective examination of 362 Mexican-origin girls and their mothers using three waves of data. Measures included girls’ self-report of pubertal development and girls’ and mothers’ report of maternal harsh parenting and daughters’ mental health. Using structural equation modeling, we examined whether pubertal timing in 5th grade predicted girls’ internalizing and externalizing outcomes in 10th grade. We also examined the mediating and moderating effects of harsh parenting on the relations between pubertal timing and internalizing and externalizing behaviors, as well as the influence of mothers’ and daughters’ nativity on these relations. Results differed depending on reporter and maternal nativity. Using daughters’ report, Mexican American mothers’ harsh parenting acted as a moderator. At high levels of harsh parenting, early pubertal timing predicted higher externalizing scores, while at low levels of harsh parenting, early timing predicted lower externalizing scores. For Mexican immigrant mothers, harsh parenting mediated the effects of pubertal timing on girls’ internalizing and externalizing problems. There were no significant pubertal effects for mothers’ report. Findings suggest that maternal harsh parenting plays a key role in the relations between early pubertal timing and behavioral and emotional outcomes among Mexican-origin girls. PMID:23231686

Trajectories of maternal depressive symptoms during pregnancy and the first 12 months postpartum and child externalizing and internalizing behavior at three years

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Kehler, Heather; Austin, Marie-Paule; Mughal, Muhammad Kashif; Wajid, Abdul; Vermeyden, Lydia; Benzies, Karen; Brown, Stephanie; Stuart, Scott; Giallo, Rebecca

2018-01-01

Background Most evidence of the association between maternal depression and children’s development is limited by being cross-sectional. To date, few studies have modelled trajectories of maternal depressive symptoms from pregnancy through the early postpartum years and examined their association with social emotional and behavior functioning in preschool children. The objectives of this study were to: 1) identify distinct groups of women defined by their trajectories of depressive symptoms across four time points from mid-pregnancy to one year postpartum; and 2) examine the associations between these trajectories and child internalizing and externalizing behaviors. Methods We analyzed data from the All Our Families (AOF) study, a large, population based pregnancy cohort of mother-child dyads in Alberta, Canada. The AOF study is an ongoing pregnancy cohort study designed to investigate relationships between the prenatal and early life period and outcomes for children and mothers. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Children’s behavioral functioning at age 3 was assessed using the Behavior Scales developed for the Canadian National Longitudinal Survey of Children and Youth. Longitudinal latent class analysis was conducted to identify trajectories of women’s depressive symptoms across four time points from pregnancy to 1 year postpartum. We used multivariable logistic regression to assess the relationship between trajectories of maternal depressive symptoms and children’s behavior, while adjusting for other significant maternal, child and psychosocial factors. Results 1983 participants met eligibility criteria. We identified four distinct trajectories of maternal depressive symptoms: low level (64.7%); early postpartum (10.9%); subclinical (18.8%); and persistent high (5.6%). In multivariable models, the proportion of children with elevated behavior symptoms was highest for children whose mothers had

Coparenting Behaviors as Mediators Between Postpartum Parental Depressive Symptoms and Toddler’s Symptoms

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Hervé Tissot

2016-12-01

Full Text Available Postpartum parental depression, even of mild intensity and short duration, has negative consequences on child development, including increased externalizing and internalizing symptoms. Studies revealed that the links between parental depression and child development are mediated by parenting difficulties. On the other hand, the mediating role of problematic family-level relationships, such as low coparenting support and high conflict between the parents, has rarely been considered, although coparenting difficulties have been linked with both increased depressive symptoms in parents and increased symptoms in toddlers. In the present study, we proposed testing a comprehensive mediation model linking parental depression, coparenting, and child symptoms. At 3 months postpartum, a convenience sample of 69 parental couples completed the Edinburgh Postnatal Depression Scale. In addition, we assessed levels of coparenting support and conflict during a mother–father–infant play situation, the Lausanne Trilogue Play. At 18 months postpartum, both parents assessed child symptoms with the Symptom Checklist Questionnaire. The results showed that coparenting support mediated the links between parental depressive symptoms and child symptoms, but only for mothers: Maternal depressive symptoms were linked with lower coparenting support, which in turn predicted increased psychofunctional symptoms and behavior problems assessed by mothers. Although coparenting conflict behaviors were not predicted by parents’ depressive symptoms, higher conflict was unexpectedly linked with fewer behavior problems assessed by both parents. The present study allowed us to unveil complex pathways between mild parental mood disturbances, family-level relationships, and child development in the first months of the child’s life.

Childhood physical maltreatment with physical injuries is associated with higher adult psychopathology symptoms.

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Lamela, Diogo; Figueiredo, Bárbara

2018-05-29

Previous research has neglected the distinction between childhood physical maltreatment (CPM) behaviors and the physical sequelae resulting from CPM. Prior empirical work has combined CPM behaviors (e.g., beat, hit with a belt) and CPM physical sequelae (e.g., bruises, fractures) into a single conceptual category to predict adverse psychological consequences in adults. This is preventing the examination whether specific subgroups of CPM exposure may report a higher risk of psychopathology symptoms in adulthood. The aim of this study was to examine whether distinct experiences of CPM histories (no physical maltreatment, physical maltreatment only, and physical maltreatment with physical sequelae) would be differentially associated with specific psychopathology dimensions in adulthood. symptoms METHOD: Data were drawn from the Portuguese National Representative Study of Psychosocial Context of Child Abuse and Neglect (N = 941). Participants completed the Childhood History Questionnaire and the Brief Symptom Inventory. Three groups were created based on participants' experience of CPM assessed by the Childhood History Questionnaire. Participants who reported that suffered physical sequelae of the CPM exhibited significantly higher symptoms in all psychopathology dimensions than participants with no history of CPM and participants that were exposed to physical maltreatment without sequelae. These findings suggest that clinicians should discriminate CPM behavior from CPM physical sequelae in order to increase effectiveness of mental health treatment with adults with history of CPM. Our findings are discussed in light of the evolutionary-developmental frameworks of adaptative development and cumulative risk hypothesis. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Do post-trauma symptoms mediate the relation between neurobiological stress parameters and conduct problems in girls?

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Babel, Kimberly A; Jambroes, Tijs; Oostermeijer, Sanne; van de Ven, Peter M; Popma, Arne; Vermeiren, Robert R J M; Doreleijers, Theo A H; Jansen, Lucres M C

2016-01-01

Attenuated activity of stress-regulating systems has consistently been reported in boys with conduct problems. Results in studies of girls are inconsistent, which may result from the high prevalence of comorbid post-trauma symptoms. Therefore, the aim of the present study is to investigate post-trauma symptoms as a potential mediator in the relation between stress-regulation systems functioning and conduct problems in female adolescents. The sample consisted of 78 female adolescents (mean age 15.4; SD 1.1) admitted to a closed treatment institution. The diagnosis of disruptive behaviour disorder (DBD) was assessed by a structured interview-the diagnostic interview schedule for children version IV (DISC-IV). To assess post-trauma symptoms and externalizing behaviour problems, self-report questionnaires, youth self report (YSR) and the trauma symptom checklist for Children (TSCC) were used. The cortisol awakenings response (CAR) measured hypothalamic-pituitary-adrenal (HPA) axis activity, whereas autonomous nervous system (ANS) activity was assessed by heart rate (HR), pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA). Independent t-tests were used to compare girls with and without DBD, while path analyses tested for the mediating role of post- trauma symptoms in the relation between stress regulating systems and externalizing behaviour. Females with DBD (n = 37) reported significantly higher rates of post-trauma symptoms and externalizing behaviour problems than girls without DBD (n = 39). Path analysis found no relation between CAR and externalizing behaviour problems. With regard to ANS activity, positive direct effects on externalizing behaviour problems were present for HR (standardized β = 0.306, p = 0.020) and PEP (standardized β = -0.323, p = 0.031), though not for RSA. Furthermore, no relation-whether direct or indirect-could be determined from post-trauma symptoms. Present findings demonstrate that the neurobiological

Higher sleep reactivity and insomnia mutually aggravate depressive symptoms: a cross-sectional epidemiological study in Japan.

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Nakajima, Shun; Komada, Yoko; Sasai-Sakuma, Taeko; Okajima, Isa; Harada, Yutaka; Watanabe, Kazue; Inoue, Yuichi

2017-05-01

Sleep reactivity assessed using the Ford Insomnia Response to Stress Test (FIRST) is associated with depression. This study clarified stress reactivity and insomnia effects on depressive symptoms. A cross-sectional questionnaire survey was administered to 2645 participating government employees (35.4% female, mean age 42.8 years) during health checks conducted at Tottori prefecture, Japan, in June 2012. Questionnaire items included: demographic information; the FIRST; the Pittsburgh Sleep Quality Index (PSQI); and a 12-item version of the Center for Epidemiological Studies Depression scale (CES-D). The study defined CES-D scores of ≥12 points as positive for depression, PSQI scores of ≥5.5 points as positive for insomnia symptoms, and FIRST scores of ≥19 points as indicating higher sleep reactivity. Multivariate logistic regression analysis revealed insomnia (adjusted OR = 3.40), higher sleep reactivity (adjusted OR = 1.78), presence of disease currently being treated (adjusted OR = 1.84), and being female (adjusted OR = 1.53) as independently associated with depression. Participants with insomnia and a high FIRST score showed higher CES-D scores than those with insomnia alone and those with high FIRST without insomnia (all p insomnia. Elevated sleep reactivity and insomnia symptoms are thought to aggravate depressive symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.

Cognitive-behavioral therapy for externalizing disorders: A meta-analysis of treatment effectiveness.

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Battagliese, Gemma; Caccetta, Maria; Luppino, Olga Ines; Baglioni, Chiara; Cardi, Valentina; Mancini, Francesco; Buonanno, Carlo

2015-12-01

Externalizing disorders are the most common and persistent forms of maladjustment in childhood. The aim of this study was to conduct a meta-analysis evaluating the effectiveness of Cognitive Behavioral Therapy (CBT) to reduce externalizing symptoms in two disorders: Attention Deficit Hyperactivity Disorder (ADHD) and Oppositive Defiant Disorder (ODD). The efficacy of CBT to improve social competence and positive parenting and reduce internalizing behaviors, parent stress and maternal depression was also explored. The database PsycInfo, PsycARTICLES, Medline and PubMed were searched to identify relevant studies. Twenty-one trials met the inclusion criteria. Results showed that the biggest improvement, after CBT, was in ODD symptoms (-0.879) followed by parental stress (-0.607), externalizing symptoms (-0.52), parenting skills (-0.381), social competence (-0.390) and ADHD symptoms (-0.343). CBT was also associated with improved attention (-0.378), aggressive behaviors (-0.284), internalizing symptoms (-0.272) and maternal depressive symptoms (-0.231). Overall, CBT is an effective treatment option for externalizing disorders and is also associated with reduced parental distress and maternal depressive symptoms. Multimodal treatments targeting both children and caregivers' symptoms (e.g. maternal depressive symptoms) appear important to produce sustained and generalized benefits. Copyright © 2015 Elsevier Ltd. All rights reserved.

A 12-week rehabilitation program improves body composition, pain sensation, and internal/external torques of baseball pitchers with shoulder impingement symptom.

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Cha, Jun-Youl; Kim, Jae-Hak; Hong, Ju; Choi, Young-Tae; Kim, Min-Ho; Cho, Ji-Hyun; Ko, Il-Gyu; Jee, Yong-Seok

2014-02-01

The aim of this study was to investigate the effects of a 12-week rehabilitation program on body composition, shoulder pain, and isokinetic internal/external torques of pitchers with impingement syndrome. A total of 30 pitchers were divided into 2 groups: experimental group (EG, n = 16) and control group (CG, n= 14). The rehabilitation program consisted of physical therapy, warm-up, work-out, and cool-down. As results, body weight and fat mass of EG were decreased whereas muscle mass of EG was significantly increased after the experiment. The pain degrees in resting, normal daily activity, and strenuous activity on the numeric pain rating scale were significantly decreased in the EG. The internal and external peak torques (PTs) of uninvolved and involved sides of EG were increased in EG after 12 weeks. Such results provide a deficit ratio of both sides in EG close to normal values. The ratios of internal/external PTs in EG were also close to the reference values. The internal and external total works of both sides in EG were similar to the values of PT. The fatigue indices of internal and external rotators of both sides in EG were decreased. As a conclusion, a 12-week rehabilitation program reduced the shoulder pain, improved the body composition and enhanced the isokinetic shoulder internal/external rotators in EG with impingement symptoms. Also the study suggested that the rehabilitation program evened out the ratio between internal and external rotators and lowered the fatigue level after the experiment.

Affective decision-making and externalizing behaviors: the role of autonomic activity.

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Bubier, Jennifer L; Drabick, Deborah A G

2008-08-01

We tested a conceptual model involving the inter-relations among affective decision-making (indexed by a gambling task), autonomic nervous system (ANS) activity, and attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms in a largely impoverished, inner city sample of first through third grade children (N=63, 54% male). The present study hypothesized that impaired affective decision-making and decreased sympathetic and parasympathetic activation would be associated with higher levels of ADHD and ODD symptoms, and that low sympathetic and parasympathetic activation during an emotion-inducing task would mediate the relation between affective decision-making and child externalizing symptoms. In support of our model, disadvantageous decision-making on a gambling task was associated with ADHD hyperactivity/impulsivity symptoms among boys, and attenuated sympathetic activation during an emotion-inducing task mediated this relation. Support for the model was not found among girls.

Stress is associated with exercise differently among individuals with higher and lower eating disorder symptoms: An ecological momentary assessment study.

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Sala, Margarita; Brosof, Leigh C; Rosenfield, David; Fernandez, Katya C; Levinson, Cheri A

2017-12-01

Stress is associated with the maintenance of eating disorders and exercise behaviors. However, it is unclear how stress is associated with exercise and vice-versa among individuals with higher levels of eating disorder symptoms in daily life. The current study tested the moderating effect of eating disorder symptoms on the relationships between (1) daily stress and later exercise behavior and (2) daily exercise behavior and later stress. Female college students [N = 129, mean age = 19.19 (SD = 1.40)] completed the Eating Disorder Inventory-2. Participants then completed measures of stress and exercise four times daily across seven days using an automated telephone ecological momentary assessment system. Data were analyzed using multilevel models. Drive for thinness, bulimic symptoms, and body dissatisfaction significantly moderated the relationship between daily stress and later exercise (ps = .01-.05), such that higher daily stress predicted higher later exercise only in individuals who were low (but not average or high) in drive for thinness, bulimic symptoms, and body dissatisfaction symptoms. Stress is associated with exercise differentially depending on individuals' eating disorder symptoms. Our findings suggest that only individuals with lower levels of eating disorder symptoms exercise when stressed. © 2017 Wiley Periodicals, Inc.

Controllable excitation of higher-order rogue waves in nonautonomous systems with both varying linear and harmonic external potentials

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Jia, Heping; Yang, Rongcao; Tian, Jinping; Zhang, Wenmei

2018-05-01

The nonautonomous nonlinear Schrödinger (NLS) equation with both varying linear and harmonic external potentials is investigated and the semirational rogue wave (RW) solution is presented by similarity transformation. Based on the solution, the interactions between Peregrine soliton and breathers, and the controllability of the semirational RWs in periodic distribution and exponential decreasing nonautonomous systems with both linear and harmonic potentials are studied. It is found that the harmonic potential only influences the constraint condition of the semirational solution, the linear potential is related to the trajectory of the semirational RWs, while dispersion and nonlinearity determine the excitation position of the higher-order RWs. The higher-order RWs can be partly, completely and biperiodically excited in periodic distribution system and the diverse excited patterns can be generated for different parameter relations in exponential decreasing system. The results reveal that the excitation of the higher-order RWs can be controlled in the nonautonomous system by choosing dispersion, nonlinearity and external potentials.

The role of the brain-derived neurotrophic factor genotype and parenting in early life in predicting externalizing and internalizing symptoms in children with attention-deficit hyperactivity disorder.

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Park, Subin; Kim, Bung-Nyun; Kim, Jae-Won; Jung, Yeon-Kyung; Lee, Jin; Shin, Min-Sup; Yoo, Hee Jeong; Cho, Soo-Churl

2014-11-25

We aimed to determine whether early parenting is associated with externalizing and internalizing symptoms in children with attention-deficit hyperactivity disorder (ADHD) and whether such an association is affected by the brain-derived neurotrophic factor (BDNF) val66met polymorphism. The participants included 92 patients with ADHD aged 6-15 years. Measures of parenting in early life and externalizing and internalizing symptoms and the genotype of the BDNF Val66Met polymorphism were obtained. The degree to which the baby's autonomy was allowed was significantly and negatively correlated with the CDI scores in ADHD children (r = -0.38, p = 0.005). After adjusting for the child's gender, the child's age, the family's gross annual income, and the maternal education level, there was a significant interaction for the BDNF genotype and mother's positive feelings about caring in relation to the development of childhood anxiety/depression in ADHD children (F = 2.51, p = 0.011). Our results provide evidence of an interaction between the BDNF met allele and early parenting on the development of depression/anxiety symptoms.

Irritability, Externalizing, and Internalizing Psychopathology in Adolescence: Cross-Sectional and Longitudinal Associations and Moderation by Sex.

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Humphreys, Kathryn L; Schouboe, Sophie N F; Kircanski, Katharina; Leibenluft, Ellen; Stringaris, Argyris; Gotlib, Ian H

2018-04-18

Irritability is a common feature of many psychiatric disorders, including both externalizing and internalizing disorders. There is little research, however, examining associations between irritability and these symptom domains, particularly during the important developmental period of adolescence, characterized by sex differences in the prevalence of disorders. We examined the cross-sectional associations between irritability, measured with the Affective Reactivity Index, and symptoms of externalizing and internalizing domains of psychopathology, measured with the Youth Self Report, in a volunteer community sample (N = 183) of 9- to 13-year-old (M = 11.39, SD = 1.07) boys and girls (37% White/Caucasian, 8% Asian, 11% Hispanic, 8% African American, 2% Native American, 2% Pacific Islander, 28% Other, and 3% not reported). A subset of the sample (n = 112) provided data at a 2-year follow-up, used to extend these associations. There were no sex differences in levels of irritability; however, the associations between irritability and symptom domains were moderated by sex. Specifically, in girls, irritability was associated equally with externalizing and internalizing symptoms. In contrast, in boys, irritability was associated more strongly with externalizing symptoms than with internalizing symptoms. Thus, across both sexes, irritability was moderately associated with externalizing symptoms, but the association between irritability and internalizing symptoms was stronger in girls than in boys. At follow-up, sex moderated the association between baseline irritability and later externalizing and internalizing symptoms. These findings indicate that irritability is associated with both externalizing and internalizing symptoms in early adolescence and that irritability is associated with internalizing symptoms more strongly in girls than in boys.

Parenting as a Moderator of the Effects of Maternal Depressive Symptoms on Preadolescent Adjustment.

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Zalewski, Maureen; Thompson, Stephanie F; Lengua, Liliana J

2017-01-01

The purpose of this study was to examine whether parenting moderated the association between maternal depressive symptoms and initial levels and growth of preadolescent internalizing and externalizing symptoms. This study used a community sample of preadolescent children (N = 214; 8-12 years old at Time 1), measuring maternal depressive symptoms and parenting at Time 1, and preadolescent internalizing and externalizing symptoms at each year for 3 years. After modeling latent growth curves of internalizing and externalizing symptoms, growth factors were conditioned on maternal depressive symptoms, positive (acceptance and consistent discipline) and negative (rejection and physical punishment) parenting, and the interactions of depression and parenting. Maternal rejection moderated the relation of maternal depression with internalizing symptoms, such that high rejection exacerbated the effects of maternal depressive symptoms on initial levels of preadolescent internalizing problems. There were no significant interactions predicting externalizing problems. The findings highlight how specific parenting behaviors may alter the way in which maternal depressive symptoms confer risk for behavior problems.

"Always Look on the Bright Side of Life!" - Higher Hypomania Scores Are Associated with Higher Mental Toughness, Increased Physical Activity, and Lower Symptoms of Depression and Lower Sleep Complaints.

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Jahangard, Leila; Rahmani, Anahita; Haghighi, Mohammad; Ahmadpanah, Mohammad; Sadeghi Bahmani, Dena; Soltanian, Ali R; Shirzadi, Shahriar; Bajoghli, Hafez; Gerber, Markus; Holsboer-Trachsler, Edith; Brand, Serge

2017-01-01

Background: In the present study, we explored the associations between hypomania, symptoms of depression, sleep complaints, physical activity and mental toughness. The latter construct has gained interest for its association with a broad variety of favorable behavior in both clinical and non-clinical samples. Subjects and Methods: The non-clinical sample consisted of 206 young adults ( M = 21.3 years; age range: 18-24 years; 57.3% males). They completed questionnaires covering hypomania, mental toughness, symptoms of depression, physical activity, and sleep quality. Results: Higher hypomania scores were associated with higher mental toughness, increased physical activity, lower symptoms of depression and lower sleep complaints. No gender differences were observed. Higher hypomania scores were predicted by higher scores of mental toughness subscales of control and challenge, and physical activity. Conclusion: The pattern of results suggests that among a non-clinical sample of young adults, self-rated hypomania scores were associated with higher scores on mental toughness and physical activity, along with lower depression and sleep complaints. The pattern of results further suggests that hypomania traits are associated with a broad range of favorable psychological, behavioral and sleep-related traits, at least among a non-clinical sample of young adults.

The responsiveness of the International Prostate Symptom Score, Incontinence Impact Questionnaire-7 and Depression, Anxiety and Stress Scale-21 in patients with lower urinary tract symptoms.

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Choi, Edmond P H; Chin, Weng Yee; Lam, Cindy L K; Wan, Eric Y F

2015-08-01

To examine the responsiveness of a combined symptom severity and health-related quality of life measure, condition-specific health-related quality of life measure and mental health measure in patients with lower urinary tract symptoms. To establish the responsiveness of measures that accurately capture the change in health status of patients is crucial before any longitudinal studies can be appropriately planned and evaluated. Prospective longitudinal observational study. 402 patients were surveyed at baseline and 1-year using the International Prostate Symptom Score, the Incontinence Impact Questionnaire-7 and Depression, Anxiety and Stress Scales-21. The internal and external responsiveness were assessed. Surveys were conducted from March 2013-July 2014. In participants with improvements, the internal responsiveness for detecting positive changes was satisfactory in males and females for all scales, expect for the Depression subscale. The health-related quality of life question of the International Prostate Symptom Score was more externally responsive than the Incontinence Impact Questionnaire-7. The International Prostate Symptom Score and Anxiety and Stress subscales were more responsive in males than in females. The symptom questions of the International Prostate Symptom Score and Anxiety and Stress subscales were not externally responsive in females. The health-related quality of life question of the International Prostate Symptom Score outperformed the Incontinence Impact Questionnaire-7 in both males and females, in terms of external responsiveness. © 2015 John Wiley & Sons Ltd.

Associations of parenting dimensions and styles with externalizing problems of children and adolescents: An updated meta-analysis.

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Pinquart, Martin

2017-05-01

The present meta-analysis integrates research from 1,435 studies on associations of parenting dimensions and styles with externalizing symptoms in children and adolescents. Parental warmth, behavioral control, autonomy granting, and an authoritative parenting style showed very small to small negative concurrent and longitudinal associations with externalizing problems. In contrast, harsh control, psychological control, authoritarian, permissive, and neglectful parenting were associated with higher levels of externalizing problems. The strongest associations were observed for harsh control and psychological control. Parental warmth, behavioral control, harsh control, psychological control, autonomy granting, authoritative, and permissive parenting predicted change in externalizing problems over time, with associations of externalizing problems with warmth, behavioral control, harsh control, psychological control, and authoritative parenting being bidirectional. Moderating effects of sampling, child's age, form of externalizing problems, rater of parenting and externalizing problems, quality of measures, and publication status were identified. Implications for future research and practice are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Correlation between symptoms and external characteristics of cracked teeth: Findings from The National Dental Practice-Based Research Network.

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Hilton, Thomas J; Funkhouser, Ellen; Ferracane, Jack L; Gilbert, Gregg H; Baltuck, Camille; Benjamin, Paul; Louis, David; Mungia, Rahma; Meyerowitz, Cyril

2017-04-01

Cracked teeth are ubiquitous in the adult dentition. The objective of this study was to determine which patient traits and behaviors and external tooth and crack characteristics correlate with cracked teeth being symptomatic. Dentists in The National Dental Practice-Based Research Network enrolled a convenience sample of patients each with a single, vital posterior tooth with at least 1 observable external crack in this observational study; they enrolled 2,975 cracked teeth from 209 practitioners. The authors collected data at the patient level, tooth level, and crack level. They used generalized estimating equations to obtain significant (P crack. Characteristics positively associated with cracked tooth symptoms, after adjusting for demographics, included patients who clenched, ground, or pressed their teeth together (OR, 1.30; 95% confidence interval [CI], 1.12-1.50), molars (OR, 1.58; 95% CI, 1.30-1.92), teeth with a wear facet through enamel (OR, 1.22; 95% CI, 1.01-1.40), carious lesions (OR, 1.31; 95% CI, 1.07-1.60), cracks that were on the distal surface of the tooth (OR, 1.31; 95% CI, 1.13-1.52), and cracks that blocked transilluminated light (OR, 1.31, 95% CI, 1.09-1.57). Teeth with stained cracks were negatively associated with having cracked tooth symptoms (OR, 0.68; 95% CI, 0.55-0.84). The greatest likelihood of a cracked tooth being symptomatic was found when patients reported clenching or grinding their teeth and had a molar with a distal crack that blocked transilluminated light. This information can help inform dentists in the decision-making process regarding the prognosis for a cracked tooth. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

Overgeneral autobiographical memory predicts higher prospective levels of depressive symptoms and intrusions in borderline patients.

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Van den Broeck, Kris; Pieters, Guido; Claes, Laurence; Berens, Ann; Raes, Filip

2016-11-01

Overgeneral memory (OGM), the tendency to retrieve categories of events from autobiographical memory instead of single events, is found to be a reliable predictor for future mood disturbances and post-traumatic symptom severity. Patients with borderline personality disorder (BPD) often report co-morbid episodes of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). Therefore, we investigated whether OGM would predict depression severity and (post-traumatic) stress symptoms in BPD patients. At admission (N = 54) and at six-month follow-up (N ≥ 31), BPD patients completed the Structured Clinical Interview for DSM-IV Disorders, the Assessment of DSM-IV Personality Disorders, the Autobiographical Memory Test, the Beck Depression Inventory-2nd edition (BDI-II), and the Impact of Event Scale. OGM at baseline predicted (a) higher levels of depressive symptoms at follow-up and (b) more intrusions related to a stressful event over and above baseline levels of borderline symptoms, depressive symptoms, and intrusions, respectively. No association was found between memory specificity and event-related avoidance at follow-up. Despite previous findings suggesting that OGM in BPD is less robust than in MDD and PTSD, our results suggest that memory specificity in BPD patients may have some relevance for the course of depressive and stress symptomatology in BPD.

Relational aggression and adverse psychosocial and physical health symptoms among urban adolescents.

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Williams, Jessica Roberts; Fredland, Nina; Han, Hae-Ra; Campbell, Jacquelyn C; Kub, Joan E

2009-01-01

The purpose of this study was to examine relational aggression and its relationship with adverse psychosocial and physical health symptoms among urban, African American youth. Quantitative, cross-sectional survey design. The sample consisted of 185 predominantly African American (95.1%) seventh-grade students (mean age: 13.0; female: 58%) attending 4 urban middle schools. The Children's Social Behavior Scale and Social Experience Questionnaire were used to measure relational aggression and relational victimization. The Pediatric Symptom Checklist was used to assess psychosocial difficulties, including internalizing behaviors, externalizing behaviors, and attention problems. Physical health symptoms were measured with questions about colds/flu, headaches, and stomach aches. 2-way multivariate analysis of variance revealed significant differences in externalizing behavior, with perpetrators reporting higher levels than nonperpetrators. Victims reported more internalizing behavior than nonvictims; however, this was only significant for males. For females, significant negative effects on health outcomes were found, resulting from the interaction of perpetration and victimization. Findings suggest that relational aggression is a common occurrence among urban, minority adolescents and may result in adverse health outcomes. These results provide several avenues for future research and implications for healthcare practice. Intervention strategies are needed to prevent relational aggression and continual or subsequent adverse health symptoms.

Higher Reported Levels of Depression, Stress, and Anxiety Are Associated with Increased Endorsement of ADHD Symptoms by Postsecondary Students

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Harrison, Allyson G.; Alexander, Sandra J.; Armstrong, Irene T.

2013-01-01

This study examined the extent to which postsecondary students endorse symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) and whether experienced level of stress, depression, or anxiety are associated with higher reporting of ADHD symptoms. Students attending a combined health and counseling service completed the Conners Adult ADHD Rating…

Dry Eye Disease Patients with Xerostomia Report Higher Symptom Load and Have Poorer Meibum Expressibility.

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Fostad, Ida G; Eidet, Jon R; Utheim, Tor P; Ræder, Sten; Lagali, Neil S; Messelt, Edvard B; Dartt, Darlene A

2016-01-01

The purpose of the study was to investigate if xerostomia (dry mouth) is associated with symptoms and signs of dry eye disease (DED). At the Norwegian Dry Eye Clinic, patients with symptomatic DED with different etiologies were consecutively included in the study. The patients underwent a comprehensive ophthalmological work-up and completed self-questionnaires on symptoms of ocular dryness (Ocular Surface Disease Index [OSDI] and McMonnies Dry Eye Questionnaire) and the Sjögren's syndrome (SS) questionnaire (SSQ). Three hundred and eighteen patients (52% women and 48% men) with DED were included. Patient demographics were: 0 to 19 years (1%), 20 to 39 (25%), 40 to 59 (34%), 60 to 79 (35%) and 80 to 99 (5%). Xerostomia, defined as "daily symptoms of dry mouth the last three months" (as presented in SSQ) was reported by 23% of the patients. Female sex was more common among patients with xerostomia (81%) than among non-xerostomia patients (44%; Pxerostomia (60 ± 15 years) were older than those without xerostomia (51 ± 17; Pxerostomia patients (65%) than among non-xerostomia patients (35%; Pxerostomia had a higher OSDI score (19.0 ± 10.0) than those without xerostomia (12.9 ± 8.0; Pxerostomia patients had more pathological meibum expressibility (0.9 ± 0.7) than those without xerostomia (0.7 ± 0.8; P = 0.046). Comparisons of OSDI and ocular signs were performed after controlling for the effects of sex, age and the number of systemic prescription drugs used. In conclusion, xerostomia patients demonstrated a higher DED symptom load and had poorer meibum expressibility than non-xerostomia patients.

Occurrence Of Osteomuscular Symptoms In Teachers Of A Higher Education Institution

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Danielle Aurília Ferreira Macêdo Maximino

2017-04-01

Full Text Available The objective of this study was to investigate the occurrence of musculoskeletal symptoms in teachers of a Higher Education Institution (HEI located in João Pessoa – PB. This is a descriptive research with a quantitative approach, held at the Faculties of Nursing and Medicine (FACENE/FAMENE, in the city of João Pessoa-PB. The instrument for data collection consisted of a form with objective questions and divided into two parts, the first with data characterizing the sample and the second with the Nordic Musculoskeletal Symptoms Questionnaire. The data were analyzed quantitatively in percentage numbers and distributed in graphs. The results indicated that 30 teachers accepted to participate in the study with female predominance (67%. The regions most affected in the last 12 months were: dorsal (60%, lumbar (53%, neck, shoulders, wrists and hands (47%. Of the teachers interviewed, 20% reported having had difficulties in routine activities due to discomfort in the cervical region and 27% reported having sought medical or physiotherapeutic care due to neck pain, while 20% due to pain in the shoulders, dorsal, wrist/hands and hip/thighs. As for the occurrence of symptoms in the last week, the regions with the highest frequency of pain were shoulders (40%, neck and dorsal (27%. The significant percentage in the regions cited certifies that they are the regions most burdened in the professors and, therefore, deserve special attention in possible projects of occupational preventive action. This research evidences the necessity of new approaches and deepening on the subject, including the formulation of intervention strategies in the process of sickness of teachers. Descriptors: Work-Related Musculoskeletal Disorders. University Teachers. Worker's Health.

Treatments that generate higher number of adverse drug reactions and their symptoms

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Lucía Fernández-López

2015-12-01

Full Text Available Objectives: Adverse drug reactions (ADRs are an important cause of morbidity and mortality worldwide and generate high health costs. Therefore, the aims of this study were to determine the treatments which produce more ADRs in general population and the main symptoms they generate. Methods: An observational, cross-sectional study consisting in performing a self-rated questionnaire was carried out. 510 patients were asked about the treatments, illnesses and ADRs, they had suffered from. Results: 26.7% of patients had suffered from some ADR. Classifying patients according to the type of prescribed treatment and studying the number of ADR that they had, we obtained significant differences (p ≤ 0.05 for treatments against arthrosis, anemia and nervous disorders (anxiety, depression, insomnia. Moreover, determining absolute frequencies of these ADRs appearance in each treatment, higher frequencies were again for drugs against arthrosis (22.6% of patients treated for arthrosis suffered some ADR, anemia (14.28%, nerve disorders (13.44% and also asthma (16%. Regarding the symptoms produced by ADRs, the most frequent were gastrointestinal (60% of patients who suffered an ADR, had gastrointestinal symptoms and nervous alterations (dizziness, headache, sleep disturbances etc (24.6%. Conclusion: Therapeutic groups which produce more commonly ADRs are those for arthrosis, anemia, nervous disorders and asthma. In addition, symptoms which are generated more frequently are gastrointestinal and nervous problems. This is in accordance with the usual side effects of mentioned treatments. Health professionals should be informed about it, so that they would be more alert about a possible emergence of an ADR in these treatments. They also could provide enough information to empower patients and thus, they probably could detect ADR events. This would facilitate ADR detection and would avoid serious consequences generated to both patients' health and health economics.

The Role of Masculinity and Depressive Symptoms in Predicting Suicidal Ideation in Homeless Men.

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Genuchi, Matthew C

2018-02-20

Men's suicide rates may be influenced by difficulties recognizing externalizing depressive symptoms in men that adhere to hegemonic masculine gender role norms. The purpose of this study was to investigate the ability of externalizing depressive symptoms, internalizing depressive symptoms, and hegemonic masculinity in predicting the existence and severity of suicidal ideation. Homeless men (n = 94) completed questionnaires at a resource center in the Rocky Mountain Western United States. Internalizing symptoms predicted the existence of suicidal ideation, and both externalizing and internalizing symptoms predicted increased severity of suicidal ideation. The masculine norms violence and playboy were correlated with men's suicidal ideation. An externalizing-internalizing model of predicting suicide in men and men's adherence to certain masculine gender role norms may be valuable to further efforts in suicide assessment and prevention.

Correlates of comorbid anxiety and externalizing disorders in childhood obsessive compulsive disorder.

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Langley, Audra K; Lewin, Adam B; Bergman, R Lindsey; Lee, Joyce C; Piacentini, John

2010-08-01

The present study examines the influence of diagnostic comorbidity on the demographic, psychiatric, and functional status of youth with a primary diagnosis of obsessive compulsive disorder (OCD). Two hundred and fifteen children (ages 5-17) referred to a university-based OCD specialty clinic were compared based on DSM-IV diagnostic profile: OCD without comorbid anxiety or externalizing disorder, OCD plus anxiety disorder, and OCD plus externalizing disorder. No age or gender differences were found across groups. Higher OCD severity was found for the OCD + ANX group, while the OCD + EXT group reported greater functional impairment than the other two groups. Lower family cohesion was reported by the OCD + EXT group compared to the OCD group and the OCD + ANX group reported higher family conflict compared to the OCD + EXT group. The OCD + ANX group had significantly lower rates of tic disorders while rates of depressive disorders did not differ among the three groups. The presence of comorbid anxiety and externalizing psychopathology are associated with greater symptom severity and functional and family impairment and underscores the importance of a better understanding of the relationship of OCD characteristics and associated disorders. Results and clinical implications are further discussed.

The association between emotional and behavioral problems and gastrointestinal symptoms among children with high-functioning autism.

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Mazefsky, Carla A; Schreiber, Dana R; Olino, Thomas M; Minshew, Nancy J

2014-07-01

This study investigated the association between gastrointestinal symptoms and a broad set of emotional and behavioral concerns in 95 children with high-functioning autism and IQ scores ≥ 80. Gastrointestinal symptoms were assessed via the Autism Treatment Network's Gastrointestinal Symptom Inventory, and data were gathered on autism symptom severity, adaptive behavior, and multiple internalizing and externalizing problems. The majority (61%) of children had at least one reported gastrointestinal symptom. Emotional and behavioral problems were also common but with a high degree of variability. Children with and without gastrointestinal problems did not differ in autism symptom severity, adaptive behavior, or total internalizing or externalizing problem scores. However, participants with gastrointestinal problems had significantly higher levels of affective problems. This finding is consistent with a small body of research noting a relationship between gastrointestinal problems, irritability, and mood problems in autism spectrum disorder. More research to identify the mechanisms underlying this relationship in autism spectrum disorder is warranted. Future research should include a medical assessment of gastrointestinal concerns, longitudinal design, and participants with a range of autism spectrum disorder severity in order to clarify the directionality of this relationship and to identify factors that may impact heterogeneity in the behavioral manifestation of gastrointestinal concerns. © The Author(s) 2013.

Anxiety and depressive symptoms are associated with higher carotid intima-media thickness. Cross-sectional analysis from ELSA-Brasil baseline data.

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Santos, Itamar S; Goulart, Alessandra C; Brunoni, André R; Kemp, Andrew H; Lotufo, Paulo A; Bensenor, Isabela M

2015-06-01

Studies focusing on the association between anxiety/depressive symptoms and accelerated subclinical atherosclerosis have yielded mixed results. Our aim is to examine associations between anxiety/depressive symptoms, common mental disorder (CMD), major depression disorder (MDD) or generalized anxiety disorder (GAD) and carotid intima-media thickness (CIMT) in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort baseline. The ELSA-Brasil baseline assessment included CIMT measurements and the Clinical Interview Schedule - Revised (CIS-R), a validated questionnaire for anxiety/depressive symptoms/diagnoses. We analyzed participants without previous coronary heart disease or stroke, and with high-quality CIMT images. We built regression models to determine whether the CIS-R score, CMD, MDD or GAD were associated with maximal CIMT levels. The study sample comprised 9744 participants. We found that individuals with higher CIS-R scores (Odds ratio for one standard deviation increase [OR]:1.12; 95% confidence interval [95%CI]:1.06-1.19), CMD (OR:1.22; 95%CI:1.07-1.38) and GAD (OR:1.19; 95%CI:1.01-1.41) had significantly higher odds of being classified in the highest age, sex and race-specific CIMT quartile. In the linear models, after adjustment for traditional cardiovascular risk factors, higher CIS-R scores (β:0.005; P = 0.010) and GAD (β:0.010; P = 0.049) were independently associated with CIMT values. Individuals with more symptoms of anxiety and/or depression, or diagnoses of CMD or GAD, had higher CIMT values, compared to peers of same age, sex and race. CIS-R scores and GAD were independently associated with higher CIMT values. These results suggest an association between anxiety/depressive symptoms (and, most notably, GAD) and accelerated subclinical atherosclerosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Outcome of endobronchial electrocautery versus external beam radiotherapy or both together in the palliative management of non-small cell lung cancer

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Samah M. Shehata

2013-01-01

Conclusions: The replacement of external radiation with bronchoscopic therapy may not be a recommended option, but its addition to XRT may be a relatively simple method of augmenting the symptom palliative effect, providing higher response rates for re-expansion of collapsed lung and reducing endobronchial obstruction endoscopically.

Factor Structure of the PTSD Checklist for DSM-5: Relationships Among Symptom Clusters, Anger, and Impulsivity.

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Armour, Cherie; Contractor, Ateka; Shea, Tracie; Elhai, Jon D; Pietrzak, Robert H

2016-02-01

Scarce data are available regarding the dimensional structure of Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) posttraumatic stress disorder (PTSD) symptoms and how factors relate to external constructs. We evaluated six competing models of DSM-5 PTSD symptoms, including Anhedonia, Externalizing Behaviors, and Hybrid models, using confirmatory factor analyses in a sample of 412 trauma-exposed college students. We then examined whether PTSD symptom clusters were differentially related to measures of anger and impulsivity using Wald chi-square tests. The seven-factor Hybrid model was deemed optimal compared with the alternatives. All symptom clusters were associated with anger; the strongest association was between externalizing behaviors and anger (r = 0.54). All symptom clusters, except re-experiencing and avoidance, were associated with impulsivity, with the strongest association between externalizing behaviors and impulsivity (r = 0.49). A seven-factor Hybrid model provides superior fit to DSM-5 PTSD symptom data, with the externalizing behaviors factor being most strongly related to anger and impulsivity.

Are infants differentially sensitive to parenting? Early maternal care, DRD4 genotype and externalizing behavior during adolescence.

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Nikitopoulos, Jörg; Zohsel, Katrin; Blomeyer, Dorothea; Buchmann, Arlette F; Schmid, Brigitte; Jennen-Steinmetz, Christine; Becker, Katja; Schmidt, Martin H; Esser, Günter; Brandeis, Daniel; Banaschewski, Tobias; Laucht, Manfred

2014-12-01

Insensitive and unresponsive caregiving during infancy has been linked to externalizing behavior problems during childhood and adolescence. The 7-repeat (7r) allele of the dopamine D4 receptor (DRD4) gene has meta-analytically been associated with a heightened susceptibility to adverse as well as supportive environments. In the present study, we examined long-term effects of early maternal care, DRD4 genotype and the interaction thereof on externalizing and internalizing psychopathology during adolescence. As part of an ongoing epidemiological cohort study, early maternal care was assessed at child's age 3 months during a nursing and playing situation. In a sample of 296 offspring, externalizing and internalizing symptoms were assessed using a psychiatric interview conducted at age 15 years. Parents additionally filled out a questionnaire on their children's psychopathic behaviors. Results indicated that adolescents with the DRD4 7r allele who experienced less responsive and stimulating early maternal care exhibited more symptoms of ADHD and CD/ODD as well as higher levels of psychopathic behavior. In accordance with the hypothesis of differential susceptibility, 7r allele carriers showed fewer ADHD symptoms and lower levels of psychopathic behavior when exposed to especially beneficial early caregiving. In contrast, individuals without the DRD4 7r allele proved to be insensitive to the effects of early maternal care. This study replicates earlier findings with regard to an interaction between DRD4 genotype and early caregiving on externalizing behavior problems in preschoolers. It is the first one to imply continuity of this effect until adolescence. Copyright © 2014 Elsevier Ltd. All rights reserved.

Redefining External Stakeholders in Nordic Higher Education

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Musial, Kazimierz

2010-01-01

Present higher education reforms in the Nordic countries diminish the role and influence of the state on the governance of higher education institutions. While still providing a framework for the management of higher education, in general, the state supervises rather than controls higher education institutions (HEIs). The rhetoric of change…

Sleep problems predict comorbid externalizing behaviors and depression in young adolescents with attention-deficit/hyperactivity disorder.

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Becker, Stephen P; Langberg, Joshua M; Evans, Steven W

2015-08-01

Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) experience high rates of sleep problems and are also at increased risk for experiencing comorbid mental health problems. This study provides an initial examination of the 1-year prospective association between sleep problems and comorbid symptoms in youth diagnosed with ADHD. Participants were 81 young adolescents (75 % male) carefully diagnosed with ADHD and their parents. Parents completed measures of their child's sleep problems and ADHD symptoms, oppositional defiant disorder (ODD) symptoms, and general externalizing behavior problems at baseline (M age = 12.2) and externalizing behaviors were assessed again 1 year later. Adolescents completed measures of anxiety and depression at both time-points. Medication use was not associated with sleep problems or comorbid psychopathology symptoms. Regression analyses indicated that, above and beyond demographic characteristics, ADHD symptom severity, and initial levels of comorbidity, sleep problems significantly predicted greater ODD symptoms, general externalizing behavior problems, and depressive symptoms 1 year later. Sleep problems were not concurrently or prospectively associated with anxiety. Although this study precludes making causal inferences, it does nonetheless provide initial evidence of sleep problems predicting later comorbid externalizing behaviors and depression symptoms in youth with ADHD. Additional research is needed with larger samples and multiple time-points to further examine the interrelations of sleep problems and comorbidity.

Traumatismes externes du larynx | Ghorbal | Journal Tunisien d'ORL ...

African Journals Online (AJOL)

Le but de ce travail est de rappeler la présentation clinique des traumatismes externes du larynx et d'étayer notre attitude dans la prise en charge de ces ... Introduction: External laryngeal trauma is rare but acutely life-threatening. ... The main presenting symptoms were hoarseness, cervical pain, dyspnea and bleeding.

Risk and protective factors for internalizing and externalizing outcomes among HIV-affected youth in Haiti.

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Li, Michelle; Betancourt, Theresa; Eustache, Eddy; Oswald, Catherine; Louis, Ermaze; Mukherjee, Joia; Surkan, Pamela J; Smith Fawzi, Mary C

2015-01-01

The present study aims to: (1) estimate the levels of internalizing symptoms and externalizing behaviors among youth affected by HIV in central Haiti; and (2) examine the risk and protective factors associated with these outcomes to identify potential areas of intervention for HIV-affected youth. Baseline data for 492 youth affected by HIV (ages 10-17) and their 330 caregivers were collected for a pilot study of a psychosocial support intervention. Participants were recruited from a list of HIV-positive patients receiving care at Partners In Health/Zanmi Lasante clinic sites. Internalizing and externalizing behaviors were assessed using the Strengths and Difficulties Questionnaire. Demographic, economic, and social indicators were collected using a structured questionnaire administered by trained social workers. Youth affected by HIV in central Haiti displayed high levels of internalizing and, to a lesser degree, externalizing symptoms. Multivariate regression analysis demonstrated risk factors most strongly associated with internalizing symptoms (socioeconomic status, parental depressive symptoms) and externalizing behaviors (household living arrangements, such as living with a stepparent). Social support had a protective effect on externalizing behaviors for both caregiver (β=-0.03, p=0.01) and self-report (β=-0.05, pHaiti and similar resource-limited settings.

The influence of external environment factors on the activity of higher educational establishments in the Russian Federation

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Olga Leonidovna Guzakova

2014-05-01

Full Text Available The instability of market economy development causes continuous changes in the activity of higher educational establishments. The article deals with the processes, taking place in the system of higher professional education in the Russian Federation in recent decades. On the basis of the analysis of statistical data and normative acts of the Government and Ministry of Education and Science of the Russian Federation, the key global and national trends in higher education are identified: increasing demand for higher education, resulted in its considerable offer (the growth of quantitative indicators is not always accompanied by improvement of higher education quality; reduction in the total number of students due to the demographic situation worsening; transition to a multi-level system of higher education under the Bologna process; change in specialties patterns and directions of training specialists with higher professional education due to the economy structural reforms and labor market needs; aggravation of competition. The tendencies lead to the emergence of demographic, political and economic risks. To reduce negative impact of the external risks to the universities’ activity it is necessary to develop corresponding state educational policy in the sphere of higher education and risk management in universities

Symptoms of Allergic Rhinitis in Women during Early Pregnancy Are Associated with Higher Prevalence of Allergic Rhinitis in Their Offspring

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Miwa Shinohara

2007-01-01

Results: Offspring whose mothers had any AR symptoms during early pregnancy showed a significantly higher adjusted odds ratio for the onset of AR in offspring than those whose mothers had no symptoms during pregnancy (adjusted Odds Ratio: 6.26, p=0.036. However, the symptoms of AR during late pregnancy showed no effects on the odds ratio. In contrast, the presence or absence of AR symptoms during early or late pregnancy showed no association with the prevalence of food allergy, atopic dermatitis or asthma in offspring. Conclusions: Our results suggest the presence of possible epigenetic mechanisms regulating the onset of AR in humans presumably through increased organ-specific hypersensitivity.

“Always Look on the Bright Side of Life!” – Higher Hypomania Scores Are Associated with Higher Mental Toughness, Increased Physical Activity, and Lower Symptoms of Depression and Lower Sleep Complaints

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Leila Jahangard

2017-12-01

Full Text Available Background: In the present study, we explored the associations between hypomania, symptoms of depression, sleep complaints, physical activity and mental toughness. The latter construct has gained interest for its association with a broad variety of favorable behavior in both clinical and non-clinical samples.Subjects and Methods: The non-clinical sample consisted of 206 young adults (M = 21.3 years; age range: 18–24 years; 57.3% males. They completed questionnaires covering hypomania, mental toughness, symptoms of depression, physical activity, and sleep quality.Results: Higher hypomania scores were associated with higher mental toughness, increased physical activity, lower symptoms of depression and lower sleep complaints. No gender differences were observed. Higher hypomania scores were predicted by higher scores of mental toughness subscales of control and challenge, and physical activity.Conclusion: The pattern of results suggests that among a non-clinical sample of young adults, self-rated hypomania scores were associated with higher scores on mental toughness and physical activity, along with lower depression and sleep complaints. The pattern of results further suggests that hypomania traits are associated with a broad range of favorable psychological, behavioral and sleep-related traits, at least among a non-clinical sample of young adults.

Using Smartphones to Monitor Bipolar Disorder Symptoms: A Pilot Study.

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Beiwinkel, Till; Kindermann, Sally; Maier, Andreas; Kerl, Christopher; Moock, Jörn; Barbian, Guido; Rössler, Wulf

2016-01-06

Relapse prevention in bipolar disorder can be improved by monitoring symptoms in patients' daily life. Smartphone apps are easy-to-use, low-cost tools that can be used to assess this information. To date, few studies have examined the usefulness of smartphone data for monitoring symptoms in bipolar disorder. We present results from a pilot test of a smartphone-based monitoring system, Social Information Monitoring for Patients with Bipolar Affective Disorder (SIMBA), that tracked daily mood, physical activity, and social communication in 13 patients. The objective of this study was to investigate whether smartphone measurements predicted clinical symptoms levels and clinical symptom change. The hypotheses that smartphone measurements are (1) negatively related to clinical depressive symptoms and (2) positively related to clinical manic symptoms were tested. Clinical rating scales were administered to assess clinical depressive and manic symptoms. Patients used a smartphone with the monitoring app for up to 12 months. Random-coefficient multilevel models were computed to analyze the relationship between smartphone data and externally rated manic and depressive symptoms. Overall clinical symptom levels and clinical symptom changes were predicted by separating between-patient and within-patient effects. Using established clinical thresholds from the literature, marginal effect plots displayed clinical relevance of smartphone data. Overall symptom levels and change in clinical symptoms were related to smartphone measures. Higher overall levels of clinical depressive symptoms were predicted by lower self-reported mood measured by the smartphone (beta=-.56, Psmartphone (ie, cell tower movements: beta=-.11, P=.03). Higher overall levels of clinical manic symptoms were predicted by lower physical activity on the smartphone (ie, distance travelled: beta=-.37, Psmartphone (beta=-.17, Psmartphone measurements, but not all smartphone measures predicted the occurrence of

Acute external otitis as debut of acute myeloid leukemia - A case and review of the literature.

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Slengerik-Hansen, Joachim; Ovesen, Therese

2018-03-01

Acute leukemia is a well known childhood cancer. The relation between leukemia and otological symptoms has long been established but is highly rare as a debut symptom of leukemia. External otitis is a common condition affecting many children, and most cases are successively treated with topical medicine. Here we present a child with acute external otitis later shown to be the debut symptom of acute myeloid leukemia, to our knowledge the first specific case described. We have reviewed the literature to find red flags for suspicion of severe disease in case of acute external otitis. Copyright © 2018 Elsevier B.V. All rights reserved.

Pituitary Volume Prospectively Predicts Internalizing Symptoms in Adolescence

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Zipursky, Amy R.; Whittle, Sarah; Yucel, Murat; Lorenzetti, Valentina; Wood, Stephen J.; Lubman, Dan I.; Simmons, Julian G.; Allen, Nicholas B.

2011-01-01

Background: Early adolescence is a critical time for the development of both internalizing and externalizing disorders. We aimed to investigate whether pituitary volume, an index of hypothalamic-pituitary-adrenal (HPA) axis function, represents a vulnerability factor for the emergence of internalizing and externalizing symptoms during adolescence…

Long-term outcome of primary external dacryocystorhinostomy

International Nuclear Information System (INIS)

Baig, R.; Khan, Q.A.; Ahmad, K.

2013-01-01

Objective: To assess the long-term functional outcome of external dacryocystorhinostomy (DCR) in terms of epiphora. Study Design: Single-group cohort study. Place and Duration of Study: Section of Ophthalmology, The Aga Khan University Hospital, Karachi, from January 2000 to June 2010. Methodology: This study included adults who underwent external DCR surgery at the AKUH during January 2000 to June 2010. The main outcome measure was the proportion of patients reporting to have developed epiphora after surgery. During the telephonic interviews participants were asked if they had a recurrence (symptoms such as watering or discharge) after surgery. Individuals answering in affirmative were asked when the symptoms started. Data on age at surgery, gender and pre-operative symptoms were collected from medical records. Recurrence-free curves were calculated according to the Kaplan-Meier method. Results: A total of 44 persons who underwent DCR surgery were contactable by telephone in 2011 and all agreed to participate in the study. The mean age of the patients at the time of surgery was 48.0 A+- 15.8 years. Overall, 38.6% (17/44) participants reported having developed epiphora after surgery. The overall median recurrence-free time was 1.7 years; there was no statistically significant difference in the median recurrence-free time between men and women. Conclusion: The long-term functional outcome of external DCR surgery does not appear to be optimal and, in fact, far worse than the short-term results reported in the international literature. (author)

Perceived stress, external locus of control, and social support as predictors of psychological adjustment among female inmates with or without a history of sexual abuse.

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Asberg, Kia; Renk, Kimberly

2014-01-01

Given the growing number of women who are incarcerated across the United States, the current study investigated the relationships among female inmates' perceptions of their own stress, external locus of control (LOC), social support adequacy, and various aspects of psychological functioning. Generally, female inmates with a self-reported history of childhood sexual abuse did not differ from their nonabused counterparts on the variables of interest. Results suggested that female inmates' perceptions of higher stress, a higher degree of external LOC, and inadequate social support correlated with greater symptoms of depression and hopelessness as well as lower self-esteem. In regression analyses, stress and social support were significant predictors for depression and anxiety. In contrast, stress was the only significant predictor of hopelessness and self-esteem. Finally, none of the predictors examined here was significant in the prediction of traumatic stress. Overall, findings suggested the importance of stress and social support in the prediction of female inmates' adjustment, specifically their symptoms of depression and anxiety.

Symptoms and development of anxiety in children with or without intellectual disability.

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Green, Shulamite A; Berkovits, Lauren D; Baker, Bruce L

2015-01-01

The purpose of this study was to examine group differences in presentation and trajectory of anxiety symptoms and disorders in children with moderate to borderline intellectual disability (ID) and children with typical cognitive development (TD). Examined anxiety disorders and symptoms in children with ID (n=74) or TD (n=116) annually from ages 5 through 9 using a parent structured interview and questionnaire. Logistic regression was used to examine odds of meeting anxiety criteria and hierarchical linear modeling was used to examine anxiety trajectory. Children with ID had significantly higher rates of clinical levels of anxiety on the Child Behavior Checklist at ages 8 and 9 and higher rates of separation anxiety disorder at age 5 compared to those with TD. Children with ID were also more likely to have externalizing problems co-occurring with anxiety. The rate of increase of anxiety symptoms over time was positive and similar in the two groups, and neither group showed sex differences in anxiety rates. Results suggest that children with ID have both higher rates of anxiety across time and are delayed in showing typical decreases in separation anxiety in early childhood. Implications for intervention are discussed in terms of the importance of screening for and treating anxiety in children with ID.

Maternal Emotion Coaching, Adolescent Anger Regulation, and Siblings' Externalizing Symptoms

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Shortt, Joann Wu; Stoolmiller, Mike; Smith-Shine, Jessica N.; Eddy, J. Mark; Sheeber, Lisa

2010-01-01

Background: Increases in externalizing behaviors during the transition to adolescence may put children at risk for developing mental disorders and related problems. Although children's ability to regulate their emotions appears to be a key factor influencing risk for maladjustment, emotion processes during adolescence remain understudied. In this…

External corners as heat bridges

Energy Technology Data Exchange (ETDEWEB)

Berber, J.

1984-08-01

The maximum additional heat loss in vertical external corners depending on wall thickness is determined. In order to amire at a low k-value, a much smaller wall thickness is required in externally insulated walls than in monolithic constructions; the greater loss of heat bridge with external insulation stands in contrast to a higher loss in thick, monolithic walls. In relation to total losses, the additional losses through external corners are practically negligible.

Higher Levels of Serum Zonulin May Rather Be Associated with Increased Risk of Obesity and Hyperlipidemia, Than with Gastrointestinal Symptoms or Disease Manifestations.

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Ohlsson, Bodil; Orho-Melander, Marju; Nilsson, Peter M

2017-03-08

Zonulin is considered a biomarker of increased intestinal permeability, and elevated levels have been found in celiac disease. The primary aim of this study was to examine the association between serum zonulin levels and gastrointestinal (GI) symptoms, and secondarily, between zonulin levels and anthropometric and metabolic factors. The offspring ( n = 363) of the participants of the Malmö Diet and Cancer cardiovascular cohort (MDC-CV) were invited to an anthropometric and clinical examination, where fasting plasma glucose levels were measured. Questionnaires about lifestyle factors and medical history were completed along with the Visual Analog Scale for Irritable Bowel Syndrome (VAS-IBS). Zonulin levels were measured in serum by ELISA. Neither GI symptoms nor GI diseases had any influence on zonulin levels. Higher zonulin levels were associated with higher waist circumference ( p = 0.003), diastolic blood pressure ( p = 0.003), and glucose levels ( p = 0.036). Higher zonulin levels were associated with increased risk of overweight ( p zonulin levels among individuals reporting GI symptoms or GI diseases, but higher zonulin levels are associated with higher waist circumference, diastolic blood pressure, fasting glucose, and increased risk of metabolic diseases.

A Structural Equation Model of HIV-related Symptoms, Depressive Symptoms, and Medication Adherence.

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Yoo-Jeong, Moka; Waldrop-Valverde, Drenna; McCoy, Katryna; Ownby, Raymond L

2016-05-01

Adherence to combined antiretroviral therapy (cART) remains critical in management of HIV infection. This study evaluated depression as a potential mechanism by which HIV-related symptoms affect medication adherence and explored if particular clusters of HIV symptoms are susceptible to this mechanism. Baseline data from a multi-visit intervention study were analyzed among 124 persons living with HIV (PLWH). A bifactor model showed two clusters of HIV-related symptom distress: general HIV-related symptoms and gastrointestinal (GI) symptoms. Structural equation modeling showed that both general HIV-related symptoms and GI symptoms were related to higher levels of depressive symptoms, and higher levels of depressive symptoms were related to lower levels of medication adherence. Although general HIV-related symptoms and GI symptoms were not directly related to adherence, they were indirectly associated with adherence via depression. The findings highlight the importance of early recognition and evaluation of symptoms of depression, as well as the underlying physical symptoms that might cause depression, to improve medication adherence.

Personality assessment inventory internalizing and externalizing structure in veterans with posttraumatic stress disorder: associations with aggression.

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Van Voorhees, Elizabeth E; Dennis, Paul A; Elbogen, Eric B; Clancy, Carolina P; Hertzberg, Michael A; Beckham, Jean C; Calhoun, Patrick S

2014-01-01

Posttraumatic stress disorder (PTSD) is associated with aggressive behavior in veterans, and difficulty controlling aggressive urges has been identified as a primary postdeployment readjustment concern. Yet only a fraction of veterans with PTSD commit violent acts. The goals of this study were to (1) examine the higher-order factor structure of Personality Assessment Inventory (PAI) scales in a sample of U.S. military veterans seeking treatment for PTSD; and (2) to evaluate the incremental validity of higher-order latent factors of the PAI over PTSD symptom severity in modeling aggression. The study sample included male U.S. Vietnam (n = 433) and Iraq/Afghanistan (n = 165) veterans who were seeking treatment for PTSD at an outpatient Veterans Affairs (VA) clinic. Measures included the Clinician Administered PTSD Scale, the PAI, and the Conflict Tactics Scale. The sample was randomly split into two equal subsamples (n's = 299) to allow for cross-validation of statistically derived factors. Parallel analysis, variable clustering analysis, and confirmatory factor analyses were used to evaluate the factor structure, and regression was used to examine the association of factor scores with self-reports of aggression over the past year. Three factors were identified: internalizing, externalizing, and substance abuse. Externalizing explained unique variance in aggression beyond PTSD symptom severity and demographic factors, while internalizing and substance abuse did not. Service era was unrelated to reports of aggression. The constructs of internalizing versus externalizing dimensions of PTSD may have utility in identifying characteristics of combat veterans in the greatest need of treatment to help manage aggressive urges. Published 2014 Wiley Periodicals, Inc.

Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims

OpenAIRE

Sober?n, Carmen; Crespo, Mar?a; del Mar G?mez-Guti?rrez, Mar?a; Fern?ndez-Lansac, Violeta; Armour, Cherie

2016-01-01

Background Confirmatory factor analytic studies have shown that posttraumatic stress disorder (PTSD) symptoms included in the fifth edition of the Diagnostic and Statistical Manual Disorders (DSM-5) may be better explained by two 6-factor models (the Externalizing Behaviours model and the Anhedonia model) and a 7-factor Hybrid model. The latter model comprises the symptom clusters of intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, and anxious and dysphoric arousal....

Higher Levels of Serum Zonulin May Rather Be Associated with Increased Risk of Obesity and Hyperlipidemia, Than with Gastrointestinal Symptoms or Disease Manifestations

Directory of Open Access Journals (Sweden)

Bodil Ohlsson

2017-03-01

Full Text Available Zonulin is considered a biomarker of increased intestinal permeability, and elevated levels have been found in celiac disease. The primary aim of this study was to examine the association between serum zonulin levels and gastrointestinal (GI symptoms, and secondarily, between zonulin levels and anthropometric and metabolic factors. The offspring (n = 363 of the participants of the Malmö Diet and Cancer cardiovascular cohort (MDC-CV were invited to an anthropometric and clinical examination, where fasting plasma glucose levels were measured. Questionnaires about lifestyle factors and medical history were completed along with the Visual Analog Scale for Irritable Bowel Syndrome (VAS-IBS. Zonulin levels were measured in serum by ELISA. Neither GI symptoms nor GI diseases had any influence on zonulin levels. Higher zonulin levels were associated with higher waist circumference (p = 0.003, diastolic blood pressure (p = 0.003, and glucose levels (p = 0.036. Higher zonulin levels were associated with increased risk of overweight (p < 0.001, obesity (p = 0.047, and hyperlipidemia (p = 0.048. We cannot detect altered zonulin levels among individuals reporting GI symptoms or GI diseases, but higher zonulin levels are associated with higher waist circumference, diastolic blood pressure, fasting glucose, and increased risk of metabolic diseases.

Adolescents Who are Less Religious than Their Parents are at Risk for Externalizing and Internalizing Symptoms: The Mediating Role of Parent-Adolescent Relationship Quality

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Kim-Spoon, Jungmeen; Longo, Gregory S.; McCullough, Michael E.

2012-01-01

Parents generally take pains to insure that their children adopt their own religious beliefs and practices, so what happens psychologically to adolescents who find themselves less religious than their parents? We examined the relationships among parents’ and adolescents’ religiousness, adolescents’ ratings of parent-adolescent relationship quality, and adolescents’ psychological adjustment using data from 322 adolescents and their parents. Adolescent boys who had lower organizational and personal religiousness than their parents, and girls who had lower personal religiousness than their parents, had more internalizing and externalizing psychological symptoms than did adolescents whose religiousness better matched their parents’. The apparent effects of sub-parental religiousness on adolescents’ psychological symptoms were mediated by their intermediate effects on adolescents’ ratings of the quality of their relationships with their parents. These findings identify religious discrepancies between parents and their children as an important influence on the quality of parent-adolescent relationships, with important implications for adolescents’ psychological well-being. PMID:22888785

Adolescents who are less religious than their parents are at risk for externalizing and internalizing symptoms: the mediating role of parent-adolescent relationship quality.

Science.gov (United States)

Kim-Spoon, Jungmeen; Longo, Gregory S; McCullough, Michael E

2012-08-01

Parents generally take pains to insure that their children adopt their own religious beliefs and practices, so what happens psychologically to adolescents who find themselves less religious than their parents? We examined the relationships among parents' and adolescents' religiousness, adolescents' ratings of parent-adolescent relationship quality, and adolescents' psychological adjustment using data from 322 adolescents and their parents. Adolescent boys who had lower organizational and personal religiousness than their parents, and girls who had lower personal religiousness than their parents, had more internalizing and externalizing psychological symptoms than did adolescents whose religiousness better matched their parents'. The apparent effects of subparental religiousness on adolescents' psychological symptoms were mediated by their intermediate effects on adolescents' ratings of the quality of their relationships with their parents. These findings identify religious discrepancies between parents and their children as an important influence on the quality of parent-adolescent relationships, with important implications for adolescents' psychological well-being. PsycINFO Database Record (c) 2012 APA, all rights reserved.

School-associated problem behavior in childhood and adolescence and development of adult schizotypal symptoms: a follow-up of a clinical cohort.

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Fagel, Selene; de Sonneville, Leo; van Engeland, Herman; Swaab, Hanna

2014-01-01

How school-associated behavioral problems in childhood and adolescence precede distinctive adult schizotypal symptoms was examined. Gender specific findings were explored. After 11.6 (SD = 3.1) years, 159 patients of the Department of Child and Adolescent Psychiatry of the University Medical Centre Utrecht, the Netherlands were reassessed for adult schizotypal symptoms. Severity of behavioral symptoms in childhood and adolescence using Teacher Report Form (TRF; Verhulst et al. 1997) and adult schizotypal symptoms using Schizotypal Personality Questionnaire-Revised (Raine in Schizophrenia Bulletin 17:555-564, 1991) were examined by Spearman's bivariate correlations. Multiple regression analyses were performed to determine the combined predictive value of significant TRF subscales for schizotypal symptomatology. Moderation was tested by adding the interactions of gender with TRF subscales to the models. Disregarding gender, correlational analyses revealed that TRF Total problems, in specific thought problems, social problems, and attentional problems were associated with disorganized schizotypal symptoms in adult life. TRF thought problems was also associated with future positive schizotypal symptoms. When gender was taken into account, for boys only thought problems was associated with adult positive schizotypal symptoms, whereas for girls externalizing problems, specifically attentional and aggressive problems, were associated with the higher levels of adult disorganized schizotypal symptoms. Moderated regression analyses provided trend significant evidence confirming that in girls externalizing problems were positively associated with general and disorganized schizotypal symptoms. When using teachers as informants, it was found that juvenile behavioral abnormalities were differentially associated with type of adult schizotypal symptoms, with these associations being further modified by gender.

Internalizing and Externalizing Problems in Children of War Veterans in Kosovo

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MA. Eglantina Kraja

2015-06-01

Full Text Available The aim of this study was to explore internalizing and externalizing problems in adolescent children of veterans of the war in Kosovo (1998-1999. The results of this study are quite interesting from the perspective of the dilemma for the state of the children of veterans even 15 years after the war ended. Parents’ emotional problems affect the functioning of the family in general and children in particular. Children can react to symptoms of parents by developing different symptoms as trouble sleeping, appetite loss, emotional instability or even problems in development, according to research done on children's reactions to the problems of parents explained by interactions between environment, brain and behaviour driven by trauma. The results of this study have shown that the internalizing problems have not shown gender differences, meantime externalizing problems were found higher in male participants. An interesting finding of this study was the highest scores of emotional problems in children born before and during the war, compare to those born after the war ended. We also found that anxiety problems in children [R2= .83, p < .001] were a significant predictor of internalizing problems. The assessment of the scale of positive qualities [R2= .19, p < .001] was also found to be a significant predictor for externalizing problems.Only 0.8% of the variance of internalizing problems was explained by the income. Considering that the subject of this study were adolescent children of war veterans of the 1999 conflict in Kosovo, we must take into account that the post-traumatic stress disorder is a very frequent problem among war veterans and that its impact on their personal and family life cannot be overlooked.

[Parenting stress and the reliability of parental information in the diagnostics of children and adolescents with symptoms of psychiatric and behavioral disorders].

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Irlbauer-Müller, Viktoria; Eichler, Anna; Stemmler, Mark; Moll, Gunther H; Kratz, Oliver

2017-07-01

Information from parents is regularly used in the diagnostic process of children and adolescents with psychiatric symptoms. But the reliability of this information is debatable, because the parents’ own stress can distort their perceptions of the child’s symptoms. For each of N = 68 children and adolescents (11–18 years) who were using mental health services for the first time, we evaluated the ratings of a parent and a professional clinician (internalizing, externalizing symptoms, total-problem score). In addition, parenting stress was scored on the Eltern-Belastungs-Inventars (EBI, Tröster, 2011), which measures both child-related stress and parent-related stress as well as total stress. Highly stressed parent ratings differed more from the clinicians’ ratings than the ratings of less stressed parents. Additionally, correlations showed that higher parenting stress resulted in larger differences between the parent’s and the clinician’s assessments. Multiple regressions proved the predictive value of child-caused parenting stress for these differences. These results apply for internalizing symptoms, externalizing symptoms, and total-problem score. Parenting stress should be evaluated systematically in order to carefully assess the value of the information from parents and to determine how it should be included in diagnostic and therapeutical decisions.

DSM-5 Posttraumatic Stress Disorder Symptom Structure in Disaster-Exposed Adolescents: Stability across Gender and Relation to Behavioral Problems.

Science.gov (United States)

Cao, Xing; Wang, Li; Cao, Chengqi; Zhang, Jianxin; Elhai, Jon D

2017-05-01

Given the significant modifications to posttraumatic stress disorder (PTSD) symptom criteria from DSM-IV to DSM-5, a better understanding of the dimensionality underlying DSM-5 PTSD symptoms among adolescents is needed. However, to date, whether gender moderates the latent structure of DSM-5 PTSD symptoms in youth remains unclear. Meanwhile, little is known about how distinct PTSD dimensions relate to adolescent behavioral problems. The aim of this study was to fill these gaps. A sample of 1184 disaster-exposed Chinese adolescents (53.8 % girls) with age ranging from 13 to 17 years (M = 14.3, SD = 0.8) completed the PTSD Checklist for DSM-5, and the Withdrawn, Aggressive Behavior, and Delinquent Behavior subscales of the Youth Self-Report. Confirmatory factor analyses revealed that the seven-factor hybrid PTSD model provided the best fit to the data for both girls and boys. Measurement equivalence of this model held across gender, although girls had higher mean scores than boys on some factors. Differential patterns of associations emerged between PTSD dimensions and behavioral problems, with anhedonia symptoms most strongly relating to social withdrawal, and externalizing behavior symptoms most strongly relating to aggression and delinquency. These findings further support the gender invariance and external criterion validity of the newly refined hybrid model that best represents DSM-5 PTSD symptom structure in youth, and carry implications for accurate assessment, diagnosis, and gender comparison of DSM-5 PTSD symptomatology, and potential symptom targets for PTSD intervention among adolescent disaster survivors.

Higher-order rogue wave-like solutions for a nonautonomous nonlinear Schrödinger equation with external potentials

Science.gov (United States)

Liu, Lei; Tian, Bo; Wu, Xiao-Yu; Sun, Yan

2018-02-01

Under investigation in this paper is the higher-order rogue wave-like solutions for a nonautonomous nonlinear Schrödinger equation with external potentials which can be applied in the nonlinear optics, hydrodynamics, plasma physics and Bose-Einstein condensation. Based on the Kadomtsev-Petviashvili hierarchy reduction, we construct the Nth order rogue wave-like solutions in terms of the Gramian under the integrable constraint. With the help of the analytic and graphic analysis, we exhibit the first-, second- and third-order rogue wave-like solutions through the different dispersion, nonlinearity and linear potential coefficients. We find that only if the dispersion and nonlinearity coefficients are proportional to each other, heights of the background of those rogue waves maintain unchanged with time increasing. Due to the existence of complex parameters, such nonautonomous rogue waves in the higher-order cases have more complex features than those in the lower.

Child allergic symptoms and mental well-being: the role of maternal anxiety and depression.

Science.gov (United States)

Teyhan, Alison; Galobardes, Bruna; Henderson, John

2014-09-01

To determine whether maternal mental health mediates the relationship between eczema or asthma symptoms and mental well-being in children. Analysis of 7250 children from the Avon Longitudinal Study of Parents and Children. Child mental well-being at 8 years was measured by the Strengths and Difficulties Questionnaire. Binary outcomes were high 'internalizing' (anxious/depressive) and 'externalizing' (oppositional/hyperactive) problems (high was >90th percentile). Child rash and wheeze categories were 'none'; 'early onset transient' (infancy/preschool only); 'persistent' (infancy/preschool and at school age); and 'late onset' (school age only). Maternal anxiety and depression were reported during pregnancy and when child was 8 years old. Persistent wheezing symptoms were associated with high externalizing (OR 1.74, 95% CI, 1.41-2.15) and internalizing (1.67, 1.35-2.06) problems compared with never wheeze. Maternal anxiety and depression, and disrupted child sleep, attenuated these associations. Persistent rash (externalizing: 1.74, 1.40-2.15; internalizing: 1.42, 1.16-1.74) and late onset rash (externalizing: 1.62, 1.17-2.25; internalizing: 1.46, 1.07-1.99) symptoms were associated with poorer mental well-being compared with no rash at any age. Maternal anxiety and depression, particularly when child was aged 8 years rather than during pregnancy, accounted for the association with internalizing symptoms and partly for externalizing symptoms. Sleep disruption did not mediate the association. Maternal anxiety and depression may mediate the association between child rash and wheeze and child mental well-being. Copyright © 2014 The Authors. Published by Mosby, Inc. All rights reserved.

Bifactor latent structure of attention-deficit/hyperactivity disorder (ADHD)/oppositional defiant disorder (ODD) symptoms and first-order latent structure of sluggish cognitive tempo symptoms.

Science.gov (United States)

Lee, SoYean; Burns, G Leonard; Beauchaine, Theodore P; Becker, Stephen P

2016-08-01

The objective was to determine if the latent structure of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms is best explained by a general disruptive behavior factor along with specific inattention (IN), hyperactivity/impulsivity (HI), and ODD factors (a bifactor model) whereas the latent structure of sluggish cognitive tempo (SCT) symptoms is best explained by a first-order factor independent of the bifactor model of ADHD/ODD. Parents' (n = 703) and teachers' (n = 366) ratings of SCT, ADHD-IN, ADHD-HI, and ODD symptoms on the Child and Adolescent Disruptive Behavior Inventory (CADBI) in a community sample of children (ages 5-13; 55% girls) were used to evaluate 4 models of symptom organization. Results indicated that a bifactor model of ADHD/ODD symptoms, in conjunction with a separate first-order SCT factor, was the best model for both parent and teacher ratings. The first-order SCT factor showed discriminant validity with the general disruptive behavior and specific IN factors in the bifactor model. In addition, higher scores on the SCT factor predicted greater academic and social impairment, even after controlling for the general disruptive behavior and 3 specific factors. Consistent with predictions from the trait-impulsivity etiological model of externalizing liability, a single, general disruptive behavior factor accounted for nearly all common variance in ADHD/ODD symptoms, whereas SCT symptoms represented a factor different from the general disruptive behavior and specific IN factor. These results provide additional support for distinguishing between SCT and ADHD-IN. The study also demonstrates how etiological models can be used to predict specific latent structures of symptom organization. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Children Affected by War and Armed Conflict: Parental Protective Factors and Resistance to Mental Health Symptoms.

Science.gov (United States)

Slone, Michelle; Shoshani, Anat

2017-01-01

This study examined the role of parenting styles and parental warmth in moderating relations between exposure to political life events and mental health symptoms among 277 Israeli adolescents aged 12-14 and their parents, who had been exposed to protracted periods of war, missile bombardments, and terrorism. Adolescents completed the Political Life Events (PLE) scale, Brief Symptom Inventory and questionnaires regarding parenting style and parental warmth. The primary caregiver completed the Child Behavior Checklist for assessment of the child's internalizing and externalizing symptoms. Results confirmed that severity of PLE exposure was positively correlated with psychological distress and with internalizing and externalizing symptoms. Maternal authoritativeness and warmth functioned as protective factors and had moderating effects on the relation between PLE exposure and mental health symptoms. In contrast, maternal authoritarianism exacerbated the relation between PLE exposure and children's externalizing symptoms. Fathers' parenting style and warmth had no significant relationship with children's mental health outcomes. These findings have important clinical and practical implications for parental guidance and support during periods of war and armed conflict.

Children Affected by War and Armed Conflict: Parental Protective Factors and Resistance to Mental Health Symptoms

Directory of Open Access Journals (Sweden)

Michelle Slone

2017-08-01

Full Text Available This study examined the role of parenting styles and parental warmth in moderating relations between exposure to political life events and mental health symptoms among 277 Israeli adolescents aged 12–14 and their parents, who had been exposed to protracted periods of war, missile bombardments, and terrorism. Adolescents completed the Political Life Events (PLE scale, Brief Symptom Inventory and questionnaires regarding parenting style and parental warmth. The primary caregiver completed the Child Behavior Checklist for assessment of the child’s internalizing and externalizing symptoms. Results confirmed that severity of PLE exposure was positively correlated with psychological distress and with internalizing and externalizing symptoms. Maternal authoritativeness and warmth functioned as protective factors and had moderating effects on the relation between PLE exposure and mental health symptoms. In contrast, maternal authoritarianism exacerbated the relation between PLE exposure and children’s externalizing symptoms. Fathers’ parenting style and warmth had no significant relationship with children’s mental health outcomes. These findings have important clinical and practical implications for parental guidance and support during periods of war and armed conflict.

External Correlates of the MMPI-2 Content Component Scales in Mental Health Inpatients

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Green, Bradley A.; Handel, Richard W.; Archer, Robert P.

2006-01-01

External correlates of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Content Component Scales were identified using an inpatient sample of 544 adults. The Brief Psychiatric Rating Scale (BPRS) and Symptom Checklist 90-Revised (SCL-90-R) produced correlates of the Content Component Scales, demonstrating external validity with…

Neuroanatomical Correlates of Heterotypic Comorbidity in Externalizing Male Adolescents

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Sauder, Colin L.; Beauchaine, Theodore P.; Gatzke-Kopp, Lisa M.; Shannon, Katherine E.; Aylward, Elizabeth

2012-01-01

Children and adolescents with externalizing behavior disorders including attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) often present with symptoms of comorbid internalizing psychopathology. However, few studies have examined central nervous system correlates of such comorbidity. We evaluated interactions between…

Pneumocystis jirovecii infection of the external auditory canal

African Journals Online (AJOL)

nonspecific symptoms of otorrhoea, otalgia, hearing loss, vertigo and tinnitus. Clinical findings include a mass in the external auditory canal and occasional otitis media. Destruction of the ossicles and sclerosis of the mastoid air cells, extensive bony erosion, and extension into the middle cranial fossa are rare complications.

No Higher Risk of CRPS After External Fixation of Distal Radial Fractures - Subgroup Analysis Under Randomised Vitamin C Prophylaxis.

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Zollinger, Paul E; Kreis, Robert W; van der Meulen, Hub G; van der Elst, Maarten; Breederveld, Roelf S; Tuinebreijer, Wim E

2010-02-17

Operative and conservative treatment of wrist fractures might lead to complex regional pain syndrome (CRPS) type I.In our multicenter dose response study in which patients with distal radial fractures were randomly allocated to placebo or vitamin C in a daily dose of 200mg, 500mg or 1500mg during 50 days, an operated subgroup was analyzed.48 (of 427) fractures) were operated (11.2%). Twenty-nine patients (60%) were treated with external fixation, 14 patients (29%) with K-wiring according to Kapandji and five patients (10%) with internal plate fixation. The 379 remaining patients were treated with a plaster.In the operated group of patients who received vitamin C no CRPS (0/37) was seen in comparison with one case of CRPS (Kapandji technique) in the operated group who received placebo (1/11 = 9%, p=.23). There was no CRPS after external fixation.In the conservatively treated group 17 cases of CRPS (17/379 = 4.5%) occurred in comparison with one in case of CRPS in the operated group (1/48 = 2.1%, p=.71).External fixation doesn't necessarily lead to a higher incidence of CRPS in distal radial fractures. Vitamin C may also play a role in this. This subgroup analysis in operated distal radial fractures showed no CRPS occurrence with vitamin C prophylaxis.

External radiotherapy in a pleural mesothelioma tumor

International Nuclear Information System (INIS)

Fernandez, M.C.; Garcia, J.L.; Gomez, A.; Simon, J.L.; Maillo, M.; Jimenez Torres, M. J.

1994-01-01

Pleural mesothelioma is an uncommon tumor compared with other thoracic malignancies and a 80% of the cases have asbestos exposure. From 1983 to 1992 we have examined patients suffering from malignant pleural mesothelioma treated with external radiotherapy. We treated 11 patients of which 9 were males and 2 were females. The most frequent symptom was the chest pain and all these patients underwent a torascoscopy followed by a pleasured. Of the 11 cases: 10 were malignant epithelial mesothelioma and 1 was a mixed pleural case. Afterwards, they were treated with external radiotherapy between 30 and 55 Gy, with few complications. At the moment, 5 patients are still alive and there is a survival rate of 50% at 24 and 60 months and of 25% at 120 months. We think that external radiotherapy is a good palliative treatment with few complications. (Author) 28 refs

Attention-Deficit/Hyperactivity Disorder Symptoms in Mothers and Fathers: Family Level Interactions in Relation to Parenting.

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Williamson, David; Johnston, Charlotte; Noyes, Amira; Stewart, Kurtis; Weiss, Margaret D

2017-04-01

Previous studies linking parent ADHD symptoms to parenting have typically focused on each parent individually. To provide a broader understanding of family context, in this study, levels of inattention and hyperactivity-impulsivity in mothers and fathers were examined, both individually and in combination, in relation to negative parenting and child-rearing disagreements. Two-parent families of 5 to 13 year old boys (126 with ADHD and 53 typically developing) participated. Parents reported their own ADHD symptoms and their perceptions of child-rearing disagreements. Parenting was measured using self-, partner-, and child-reports as well as observations. Controlling for child ADHD symptoms, inattention symptoms in fathers predicted parenting difficulties. For mothers, inattention symptoms were linked to parenting problems only when fathers also had high levels of inattention. In contrast, parenting was most problematic for both mothers and fathers in families in which fathers had higher and mothers had lower levels hyperactivity-impulsivity symptoms. These results remained essentially unchanged when child externalizing behavior and mother depression and hostility were controlled, but father depression reduced the significance of some interactions. The results highlight the importance of the match between father and mother levels of symptoms, and point to differential relations of parenting to inattention and hyperactivity-impulsivity symptoms in parents.

Meningitis and Pneumocephalus. A rare complication of external dacryocystorhinostomy.

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Usul, Haydar; Kuzeyli, Kayhan; Cakir, Ertugrul; Caylan, Refik; Imamoglu, H Ibrahim; Yazar, Ugur; Arslan, Erhan; Sayin, O Caglar; Arslan, Selcuk

2004-11-01

Meningitis due to fracture of the fovea ethmoidalis during external dacryocystorhinostomy is a rare complication. We report a case of pneumocephalus and meningitis in a 51-year-old female who underwent an external dacryocystorhinostomy (DCR). Although extracranial complications during or after external DCR have been well-described, only one case of meningitis has been reported in the literature. Physical examination, computerised tomography, lumbar puncture, and bacteriologic cultures were used to make the diagnosis. The patient responded well to antibiotic therapy. Her symptoms resolved immediately and she was discharged on the 21st post-operative day. This complication emphasises the importance of careful surgical technique and a thorough knowledge of regional anatomy, during DCR and similar procedures.

Parental Depression, Overreactive Parenting, and Early Childhood Externalizing Problems: Moderation by Social Support.

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Taraban, Lindsay; Shaw, Daniel S; Leve, Leslie D; Natsuaki, Misaki N; Ganiban, Jody M; Reiss, David; Neiderhiser, Jenae M

2018-02-20

This study used a large (N = 519), longitudinal sample of adoptive families to test overreactive parenting as a mediator of associations between parental depressive symptoms and early childhood externalizing, and parents' social support satisfaction as a moderator. Maternal parenting (18 months) mediated the association between maternal depressive symptoms (9 months) and child externalizing problems (27 months). Paternal parenting was not a significant mediator. Unexpectedly, we found a cross-over effect for the moderating role of social support satisfaction, such that partners' social support satisfaction reduced the strength of the association between each parent's own depressive symptoms and overreactive parenting. Results point to the importance of accounting for broader family context in predicting early childhood parenting and child outcomes. © 2018 The Authors. Child Development © 2018 Society for Research in Child Development, Inc.

Relation between epistaxis, external nasal deformity, and septal deviation following nasal trauma

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Daniel, M; Raghavan, U

2005-01-01

Objectives: To find if the presence of epistaxis after nasal trauma can be used to predict post-traumatic external nasal deformity or a symptomatic deviated nasal septum. Methods: Retrospective analysis of all patients seen in the fractured nose clinic by the first author between 17 October 2003 and 27 February 2004. Presence of epistaxis, newly developed external nasal deformity, and the presence of a deviated nasal septum with new symptoms of nasal obstruction were noted. Results: A total of 139 patients were included in the study. Epistaxis following injury was noted in 106 (76%). Newly developed external nasal deformity was noted in 71 (51%), and 33 (24%) had a deviated nasal septum with new symptoms of nasal obstruction. Of the 106 patients with post-trauma epistaxis, 50 (67%) had newly developed external nasal deformity and of the 33 patients without post-traumatic epistaxis, 11 (33%) had nasal deformity (pepistaxis was not associated with the presence of a newly symptomatic deviated septum (25% in patients with epistaxis after injury versus 18% if there was no epistaxis). Conclusions: Presence of epistaxis after nasal trauma is associated with a statistically significant increase in external nasal deformity. However, one third of patients without epistaxis following nasal trauma also had external nasal deformity and hence all patients with a swollen nose after injury, irrespective of post-trauma epistaxis, still need to be referred to the fractured nose clinic. PMID:16244333

Pathways to Children's Externalizing Behavior: A Three-Generation Study

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Brook, Judith S.; Zhang, Chenshu; Balka, Elinor B.; Brook, David W.

2012-01-01

In this study, based on Family Interactional Theory (FIT), the authors tested a longitudinal model of the intergenerational effects of the grandmothers' parent-child relationships and the grandparents' smoking on the grandchildren's externalizing behavior via parents' psychological symptoms, tobacco use, and child rearing. Using Mplus, the authors…

Homelessness among Lesbian, Gay, and Bisexual Youth: Implications for Subsequent Internalizing and Externalizing Symptoms

Science.gov (United States)

Rosario, Margaret; Schrimshaw, Eric W.; Hunter, Joyce

2012-01-01

Although lesbian, gay, and bisexual (LGB) youth with a history of homelessness (running away or being evicted from their homes by parents) report more psychological symptoms than homeless heterosexual peers, it is unclear whether symptoms are due to homelessness, given the absence of a non-homeless comparison group. This study longitudinally…

Black and White Parents' Willingness to Seek Help for Children's Internalizing and Externalizing Symptoms.

Science.gov (United States)

Thurston, Idia B; Hardin, Robin; Decker, Kristina; Arnold, Trisha; Howell, Kathryn H; Phares, Vicky

2018-01-01

Understanding social and environmental factors that contribute to parental help-seeking intentions is an important step in addressing service underutilization for children in need of treatment. This study examined factors that contribute to parents' intentions to seek formal and informal help for child psychopathology (anxiety and attention-deficit/hyperactivity disorder [ADHD]). A total of 251 parents (N = 128 mothers, N = 123 fathers; 49% Black, 51% White) read 3 vignettes describing children with anxiety, ADHD, and no diagnosis. Measures of problem recognition, perceived barriers, and formal (pediatricians, psychologists, teachers) and informal (religious leaders, family/friends, self-help) help seeking were completed. Four separate hierarchical logistic regression models were used to examine parental help-seeking likelihood from formal and informal sources for internalizing and externalizing symptoms. Predictors were socioeconomic status, parent race, age, and sex, parent problem recognition (via study vignettes), and perceived barriers to mental health service utilization. Mothers were more likely than fathers to seek help from pediatricians, psychologists, teachers, and religious leaders for child anxiety and pediatricians, religious leaders, and self-help resources for child ADHD. Black parents were more likely to seek help from religious leaders and White parents were more likely to use self-help resources. Problem recognition was associated with greater intentions to seek help from almost all formal and informal sources (except from friends/family). Understanding factors that contribute to parental help seeking for child psychopathology is critical for increasing service utilization and reducing the negative effects of mental health problems. This study highlights the importance of decreasing help-seeking barriers and increasing problem recognition to improve health equity. © 2017 Wiley Periodicals, Inc.

Cultural stressors and mental health symptoms among Mexican Americans: a prospective study examining the impact of the family and neighborhood context.

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Nair, Rajni L; White, Rebecca M B; Roosa, Mark W; Zeiders, Katharine H

2013-10-01

Studies of stress consistently have linked individuals' experiences of stress to maladjustment, but limited attention has been given to cultural stressors commonly experienced by minority individuals. To address this, the current study examined the links between cultural stressors and prospective changes in mental health symptoms in a sample of 710 (49 % female) Mexican American youth. In addition, the moderating role of both family and neighborhood cohesion was examined. In-home interviews were completed with youth, mothers (required) and fathers (optional) to collect data on youth's experiences of cultural stressors (discrimination and language hassles) and internalizing/externalizing behavior, and mothers' report of family cohesion and mothers' and fathers' report of neighborhood cohesion. Analyses revealed that youth's experiences of discrimination and language hassles at 5th grade were related positively to increases in internalizing symptoms at 7th grade. Additionally, youths who reported higher levels of language hassles in 5th grade experienced increases in externalizing symptoms across the 2-year span. Both family and neighborhood cohesion emerged as significant moderating factors but their impact was conditional on youth's gender and nativity. Limitations and future implications are discussed.

The Internal, External, and Diagnostic Validity of Sluggish Cognitive Tempo: A Meta-Analysis and Critical Review

Science.gov (United States)

Becker, Stephen P.; Leopold, Daniel R.; Burns, G. Leonard; Jarrett, Matthew A.; Langberg, Joshua M.; Marshall, Stephen A.; McBurnett, Keith; Waschbusch, Daniel A.; Willcutt, Erik G.

2015-01-01

Objective To conduct the first meta-analysis evaluating the internal and external validity of the sluggish cognitive tempo (SCT) construct as related to or distinct from attention-deficit/hyperactivity disorder (ADHD) and as associated with functional impairment and neuropsychological functioning. Method Electronic databases were searched through September 2015 for studies examining the factor structure and/or correlates of SCT in children or adults. The search procedures identified 73 papers. The core SCT behaviors included across studies, as well as factor loadings and reliability estimates, were reviewed to evaluate internal validity. Pooled correlation effect sizes using random effects models were used to evaluate SCT in relation to external validity domains (i.e., demographics, other psychopathologies, functional impairment, and neuropsychological functioning). Results Strong support was found for the internal validity of the SCT construct. Specifically, across factor analytic studies including over 19,000 individuals, 13 SCT items loaded consistently on an SCT factor as opposed to an ADHD factor. Findings also support the reliability (i.e., internal consistency, test-retest reliability, inter-rater reliability) of SCT. In terms of external validity, there is some indication that SCT may increase with age (r = 0.11) and be associated with lower socioeconomic status (r = 0.10). Modest (potentially negligible) support was found for SCT symptoms being higher in males than females in children (r = 0.05) but not adults. SCT is more strongly associated with ADHD inattention (r = 0.63 in children, r = 0.72 in adults) than with ADHD hyperactivity-impulsivity (r = 0.32 in children, r = 0.46 in adults), and it likewise appears that SCT is more strongly associated with internalizing symptoms than with externalizing symptoms. SCT is associated with significant global, social, and academic impairment (rs = 0.38–0.44). Effects for neuropsychological functioning are mixed

Associations of child insomnia, sleep movement, and their persistence with mental health symptoms in childhood and adolescence.

Science.gov (United States)

Armstrong, Jeffrey M; Ruttle, Paula L; Klein, Marjorie H; Essex, Marilyn J; Benca, Ruth M

2014-05-01

To examine the patterns of insomnia and sleep-related movement from ages 4.5 to 9 years, their concurrent associations with mental health symptoms in childhood, and the longitudinal associations of sleep-problem persistence with mental health symptoms at ages 9 and 18 years. A 14-year prospective follow-up study. Assessments included maternal report on the Children's Sleep Habits Questionnaire at ages 4.5 and 9, and child mental health symptoms via maternal report at age 4.5, multi-informant (child, teacher, mother) report at age 9, and adolescent report at age 18. Community. A total of 396 children (51% female). N/A. Sleep problems were more common at age 4.5 than 9; symptoms of insomnia and abnormal sleep movement both had persistence rates of 9-10%. At age 4.5, insomnia was associated with hostile-aggressive and hyperactive-distractible behavior, but there were no significant associations for sleep movement. At age 9, both insomnia and sleep movement were associated with symptoms of depression, externalizing, and attention deficit hyperactivity disorder (ADHD). Insomnia persistence was associated with symptoms of depression, externalizing, and ADHD at age 9 and anxiety and externalizing at age 18; sleep- movement persistence was associated with externalizing and ADHD at age 9, and ADHD at age 18. The age 18 persistence effects for insomnia and anxiety and for sleep movement and ADHD were significant when controlling for earlier mental health. Childhood insomnia and sleep movement are common and associated with mental health symptoms. Their persistence from middle to late childhood predicts associations with specific types of mental health symptoms at age 18.

Impact of ADHD symptoms on autism spectrum disorder symptom severity.

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Sprenger, Linda; Bühler, Eva; Poustka, Luise; Bach, Christiane; Heinzel-Gutenbrunner, Monika; Kamp-Becker, Inge; Bachmann, Christian

2013-10-01

Despite the official exclusion criteria for autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) in the DSM-IV and ICD-10, patients with ASD often show ADHD symptoms. We aimed to examine the potential influence of ADHD symptoms on autistic psychopathology in a large sample of patients with ASD. We tested the hypothesis that patients with ASD and an additional ADHD (ASD+) would show a higher severity of autistic symptoms than those with ASD only (ASD-). We measured autistic symptoms using the autism diagnostic observation schedule (ADOS-G), the autism diagnostic interview (ADI-R), and the social responsiveness scale (SRS). To measure overall psychopathology and ADHD symptoms, we used the child behavior checklist (CBCL) and the ADHD rating scale (FBB-ADHS), respectively. Group differences between the ASD+ and the ASD- group (group division was conducted according to the results of the FBB-ADHS) were calculated using a univariate analysis of variance (ANOVA). The ASD+ group showed a greater severity of autistic symptoms than the ASD- group, measured by the SRS and the ADI-R. Especially in the social interaction subscale (ADI-R), a significantly higher symptom severity was found in the ASD+ group. No significant group differences were found regarding autistic symptoms measured by the ADOS-G. Patients with ASD and an additional ADHD expressed a stronger severity of autistic symptoms than patients with ASD only. According to our results, the possibility of a co-diagnosis of ADS and ADHD, as is being planned in the DSM-5, is in line with earlier studies, is highly reasonable, will simplify research, and have therapeutic implications. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Danish Symptom Cohort: Questionnaire and Feasibility in the Nationwide Study on Symptom Experience and Healthcare-Seeking among 100.000 Individuals

DEFF Research Database (Denmark)

Rasmussen, Sanne; Søndergaard, Jens; Larsen, Pia Veldt

2014-01-01

experience, symptom characteristics, reaction in response to symptom experience, external factors, and personality characteristics with potential influence on the symptom experience. In total, 49 706 questionnaires were completed, yielding a response rate of 52.2%. Conclusion. We developed a comprehensive......Introduction. In order to develop strategies to prevent delay in diagnosis, it is important to gain knowledge of symptoms and healthcare-seeking processes in the population. This paper describes a combined survey and register-based study with (1) focus on development of a questionnaire concerning...... was developed. The methodological framework for the development included defining the domains to be measured, identification of previous items, scales and questionnaires in the literature, and pilot and field testing. Results. A total of five domains and 16 subdomains were defined covering the area of symptom...

Externalizing behaviors of Ukrainian children: The role of parenting.

Science.gov (United States)

Burlaka, Viktor

2016-04-01

The purpose of this study was to assess the association of positive and negative parenting with child externalizing problems. Quantitative data were collected during face-to-face interviews with 320 parents of children 9-16 years of age (50% males) in 11 communities in Eastern, Southern, and Central Ukraine. The study estimated the relationship between parenting practices and child externalizing behaviors such as aggression, delinquency, and attention problems. Results revealed that positive parenting, child monitoring, and avoidance of corporal punishment were associated with fewer child externalizing symptoms. Results also indicated that child male gender and single parenting had significant and positive association with child externalizing behaviors. This study extends international psychosocial knowledge on children and families. These findings can be used to design programs and foster dialogs about the role of family and social environments in the development of externalizing disorder among researchers, representatives of governmental and nongovernmental organizations, and mass media that work with child abuse prevention in Ukraine. Copyright © 2016 Elsevier Ltd. All rights reserved.

External noise distinguishes attention mechanisms.

Science.gov (United States)

Lu, Z L; Dosher, B A

1998-05-01

We developed and tested a powerful method for identifying and characterizing the effect of attention on performance in visual tasks as due to signal enhancement, distractor exclusion, or internal noise suppression. Based on a noisy Perceptual Template Model (PTM) of a human observer, the method adds increasing amounts of external noise (white gaussian random noise) to the visual stimulus and observes the effect on performance of a perceptual task for attended and unattended stimuli. The three mechanisms of attention yield three "signature" patterns of performance. The general framework for characterizing the mechanisms of attention is used here to investigate the attentional mechanisms in a concurrent location-cued orientation discrimination task. Test stimuli--Gabor patches tilted slightly to the right or left--always appeared on both the left and the right of fixation, and varied independently. Observers were cued on each trial to attend to the left, the right, or evenly to both stimuli, and decide the direction of tilt of both test stimuli. For eight levels of added external noise and three attention conditions (attended, unattended, and equal), subjects' contrast threshold levels were determined. At low levels of external noise, attention affected threshold contrast: threshold contrasts for non-attended stimuli were systematically higher than for equal attention stimuli, which were, in turn, higher than for attended stimuli. Specifically, when the rms contrast of the external noise is below 10%, there is a consistent 17% elevation of contrast threshold from attended to unattended condition across all three subjects. For higher levels of external noise, attention conditions did not affect threshold contrast values at all. These strong results are characteristic of a signal enhancement, or equivalently, an internal additive noise reduction mechanism of attention.

The origins of mental toughness – prosocial behavior and low internalizing and externalizing problems at age 5 predict higher mental toughness scores at age 14

Directory of Open Access Journals (Sweden)

Dena Sadeghi Bahmani

2016-08-01

Full Text Available Background: The concept of mental toughness has gained increasing importance among groups other than elite athletes by virtue of its psychological importance and explanatory power for a broad range of health-related behaviors. However, no study has focused so far on the psychological origins of mental toughness. Therefore, the aims of the present study were: to explore, to what extent the psychological profiles of preschoolers aged five were associated with both 1 mental toughness scores and 2 sleep disturbances at age 14, and 3 to explore possible gender differences.Method: Nine years after their first assessment at age five (preschoolers, a total of 77 adolescents (mean age: 14.35 years; SD = 1.22; 42% females took part in this follow-up study. At baseline, both parents and teachers completed the Strengths and Difficulties Questionnaire (SDQ, covering internalizing and externalizing problems, hyperactivity, negative peer relationships, and prosocial behavior. At follow-up, participants completed a booklet of questionnaires covering socio-demographic data, mental toughness, and sleep disturbances.Results: Higher prosocial behavior, lower negative peer relationships, and lower internalizing and externalizing problems at age five, as rated by parents and teachers, were associated with self-reported higher mental toughness and lower sleep disturbances at age 14. At age 14, and relative to males, females had lower MT scores and reported more sleep disturbances.Results: Higher prosocial behavior, lower negative peer relationships, and lower internalizing and externalizing problems at age five, as rated by parents and teachers, predicted self-reported higher mental toughness and lower sleep disturbances at age 14. At age 14, and relative to males, females had lower MT scores and reported more sleep disturbance.Conclusions: The pattern of results suggests that mental toughness traits during adolescence may have their origins in the pre-school years.

Disorganized Attachment and Inhibitory Capacity: Predicting Externalizing Problem Behaviors

Science.gov (United States)

Bohlin, Gunilla; Eninger, Lilianne; Brocki, Karin Cecilia; Thorell, Lisa B.

2012-01-01

The aim of the present study was to investigate whether attachment insecurity, focusing on disorganized attachment, and the executive function (EF) component of inhibition, assessed at age 5, were longitudinally related to general externalizing problem behaviors as well as to specific symptoms of ADHD and Autism spectrum disorder (ASD), and…

Adapting social neuroscience measures for schizophrenia clinical trials, part 3: fathoming external validity.

Science.gov (United States)

Olbert, Charles M; Penn, David L; Kern, Robert S; Lee, Junghee; Horan, William P; Reise, Steven P; Ochsner, Kevin N; Marder, Stephen R; Green, Michael F

2013-11-01

It is unknown whether measures adapted from social neuroscience linked to specific neural systems will demonstrate relationships to external variables. Four paradigms adapted from social neuroscience were administered to 173 clinically stable outpatients with schizophrenia to determine their relationships to functionally meaningful variables and to investigate their incremental validity beyond standard measures of social and nonsocial cognition. The 4 paradigms included 2 that assess perception of nonverbal social and action cues (basic biological motion and emotion in biological motion) and 2 that involve higher level inferences about self and others' mental states (self-referential memory and empathic accuracy). Overall, social neuroscience paradigms showed significant relationships to functional capacity but weak relationships to community functioning; the paradigms also showed weak correlations to clinical symptoms. Evidence for incremental validity beyond standard measures of social and nonsocial cognition was mixed with additional predictive power shown for functional capacity but not community functioning. Of the newly adapted paradigms, the empathic accuracy task had the broadest external validity. These results underscore the difficulty of translating developments from neuroscience into clinically useful tasks with functional significance.

Development and external validation of a new PTA assessment scale

NARCIS (Netherlands)

Jacobs, B.; van Ekert, J.; Vernooy, L.P.; Dieperink, P.; Andriessen, T.M.J.C.; Hendriks, M.P.; van Vugt, A.B.; Emons, M.A.; Borm, G.F.; Vos, P.E.

2012-01-01

BACKGROUND: Post-traumatic amnesia (PTA) is a key symptom of traumatic brain injury (TBI). Accurate assessment of PTA is imperative in guiding clinical decision making. Our aim was to develop and externally validate a short, examiner independent and practical PTA scale, by selecting the most

The link between infant regulatory problems, temperament traits, maternal depressive symptoms and children's psychopathological symptoms at age three: a longitudinal study in a German at-risk sample.

Science.gov (United States)

Sidor, Anna; Fischer, Cristina; Cierpka, Manfred

2017-01-01

Difficult conditions during childhood can limit an individual's development in many ways. Factors such as being raised in an at-risk family, child temperamental traits or maternal traits can potentially influence a child's later behaviour. The present study investigated the extent of regulatory problems in 6-month-old infants and their link to temperamental traits and impact on externalizing and internalizing problems at 36 months. Moderating effects of maternal distress and maternal depressive symptoms were tested as well. In a quasi-experimental, longitudinal study, a sample of 185 mother-infant dyads at psychosocial risk was investigated at 6 months with SFS (infants' regulatory problems) and at 3 years with CBCL (children's behavioural problems), EAS (children's temperament), ADS (maternal depressive symptoms) and PSI-SF (maternal stress). A hierarchical regression analysis yielded a significant association between infants' regulatory problems and both externalizing and internalizing behaviour problems at age 3 (accounting for 16% and 14% variance), with both externalizing and internalizing problems being linked to current maternal depressive symptoms (12 and 9% of the variance). Externalizing and internalizing problems were found to be related also to children's temperamental difficulty (18 and 13% of variance) and their negative emotionality. With temperamental traits having been taken into account, only feeding problems at 6 months contributed near-significant to internalizing problems at 3 years. Our results underscore the crucial role of temperament in the path between early regulatory problems and subsequent behavioural difficulties. Children's unfavourable temperamental predispositions such as negative emotionality and generally "difficult temperament" contributed substantially to both externalizing and internalizing behavioural problems in the high-risk sample. The decreased predictive power of regulatory problems following the inclusion of

Experienced stigma and its impacts in psychosis: The role of social rank and external shame.

Science.gov (United States)

Wood, Lisa; Irons, Chris

2017-09-01

Experienced stigma is detrimental to those who experience psychosis and can cause emotional distress and hinder recovery. This study aimed to explore the relationship between experienced stigma with emotional distress and recovery in people with psychosis. It explored the role of external shame and social rank as mediators in these relationships. A cross-sectional design was implemented. Fifty-two service users were administered a battery of questionnaires examining experienced stigma, external shame, social rank, personal recovery, positive symptoms, depression, and anxiety. Correlation and multiple regression analysis were conducted on the data. Where appropriate, mediation analysis was employed to explore social rank and external shame as mediatory variables. Experienced stigma was significantly related to shame (social rank and external shame), positive symptoms, emotional distress (depression and anxiety), and personal recovery. The impact of experienced stigma on depression was mediated by external shame. Social rank was a mediator between experienced stigma and personal recovery only. People with psychosis who have experienced stigma are likely to experience emotional distress and be inhibited in their recovery. This was found to be partly mediated by external shame and low social rank. Clinical approaches to stigma need to target these as potential maintenance factors. Experienced stigma is significantly related to shame (social rank and external shame) emotional distress, and reduced personal recovery. External shame mediated the relationship between experienced stigma and depression in psychosis. Social rank mediated the relationship between experienced stigma and personal recovery. Clinical approaches to stigma should include the assessment of external shame and low social rank. © 2017 The British Psychological Society.

High internal noise and poor external noise filtering characterize perception in autism spectrum disorder.

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Park, Woon Ju; Schauder, Kimberly B; Zhang, Ruyuan; Bennetto, Loisa; Tadin, Duje

2017-12-14

An emerging hypothesis postulates that internal noise is a key factor influencing perceptual abilities in autism spectrum disorder (ASD). Given fundamental and inescapable effects of noise on nearly all aspects of neural processing, this could be a critical abnormality with broad implications for perception, behavior, and cognition. However, this proposal has been challenged by both theoretical and empirical studies. A crucial question is whether and how internal noise limits perception in ASD, independently from other sources of perceptual inefficiency, such as the ability to filter out external noise. Here, we separately estimated internal noise and external noise filtering in ASD. In children and adolescents with and without ASD, we computationally modeled individuals' visual orientation discrimination in the presence of varying levels of external noise. The results revealed increased internal noise and worse external noise filtering in individuals with ASD. For both factors, we also observed high inter-individual variability in ASD, with only the internal noise estimates significantly correlating with severity of ASD symptoms. We provide evidence for reduced perceptual efficiency in ASD that is due to both increased internal noise and worse external noise filtering, while highlighting internal noise as a possible contributing factor to variability in ASD symptoms.

Child Allergic Symptoms and Mental Well-Being: The Role of Maternal Anxiety and Depression☆

Science.gov (United States)

Teyhan, Alison; Galobardes, Bruna; Henderson, John

2014-01-01

Objective To determine whether maternal mental health mediates the relationship between eczema or asthma symptoms and mental well-being in children. Study design Analysis of 7250 children from the Avon Longitudinal Study of Parents and Children. Child mental well-being at 8 years was measured by the Strengths and Difficulties Questionnaire. Binary outcomes were high ‘internalizing’ (anxious/depressive) and ‘externalizing’ (oppositional/hyperactive) problems (high was >90th percentile). Child rash and wheeze categories were ‘none’; ‘early onset transient’ (infancy/preschool only); ‘persistent’ (infancy/preschool and at school age); and ‘late onset’ (school age only). Maternal anxiety and depression were reported during pregnancy and when child was 8 years old. Results Persistent wheezing symptoms were associated with high externalizing (OR 1.74, 95% CI, 1.41-2.15) and internalizing (1.67, 1.35-2.06) problems compared with never wheeze. Maternal anxiety and depression, and disrupted child sleep, attenuated these associations. Persistent rash (externalizing: 1.74, 1.40-2.15; internalizing: 1.42, 1.16-1.74) and late onset rash (externalizing: 1.62, 1.17-2.25; internalizing: 1.46, 1.07-1.99) symptoms were associated with poorer mental well-being compared with no rash at any age. Maternal anxiety and depression, particularly when child was aged 8 years rather than during pregnancy, accounted for the association with internalizing symptoms and partly for externalizing symptoms. Sleep disruption did not mediate the association. Conclusions Maternal anxiety and depression may mediate the association between child rash and wheeze and child mental well-being. PMID:24952709

Forms of Spanking and Children’s Externalizing Behaviors

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Lansford, Jennifer E.; Wager, Laura B.; Bates, John E.; Pettit, Gregory S.; Dodge, Kenneth A.

2011-01-01

Research suggests that corporal punishment is related to higher levels of child externalizing behavior, but there has been controversy regarding whether infrequent, mild spanking predicts child externalizing or whether more severe and frequent forms of corporal punishment account for the link. Mothers rated the frequency with which they spanked and whether they spanked with a hand or object when their child was 6, 7, and 8 years old. Mothers and teachers rated children’s externalizing behaviors at each age. Analyses of covariance revealed higher levels of mother-reported externalizing behavior for children who experienced harsh spanking. Structural equation models for children who experienced no spanking or mild spanking only revealed that spanking was related to concurrent and prior, but not subsequent, externalizing. Mild spanking in one year was a risk factor for harsh spanking in the next year. Findings are discussed in the context of efforts to promote children’s rights to protection. PMID:22544988

Early maternal depressive symptom trajectories: Associations with 7-year maternal depressive symptoms and child behavior.

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Buckingham-Howes, Stacy; Oberlander, Sarah E; Wang, Yan; Black, Maureen M

2017-06-01

This study examines potential mechanisms linking maternal depressive symptoms over 2 years postpartum with child behavior problems at school-age in a sample of adolescent mothers and their first-born child. Potential mechanisms include: mother-reported caregiving engagement at 6 months; observed parental nurturance and control, and child competence and affect at 24 months; and mother-reported resilience at 7 years based on achievement of adult developmental tasks. One hundred eighteen low-income African American adolescent mothers were recruited at delivery and followed through child age 7 years. Maternal depressive symptom trajectories over 24 months were estimated (low, medium, and high) based on mother-reported depressive symptoms. Direct and indirect associations between depressive symptom trajectories with 7-year maternal depressive symptoms and child behavior problems were examined. The high maternal depressive symptom trajectory was associated with 7-year maternal depressive symptoms (b = 5.52, SE = 1.65, p child internalizing problems (b = 7.60, SE = 3.12, p = .02) and externalizing problems (b = 6.23, SE = 3.22, p = .05). Caregiving engagement among high depressive symptom trajectory mothers was significantly associated with observed child affect (b = -0.21, SE = 0.11, p = 0.05). Parental nurturance in toddlerhood mediated the association between high maternal depressive symptom trajectory and child internalizing problems at 7 years (indirect effect b = 2.33, 95% CI: 0.32-5.88). Findings suggest that family based interventions to promote parenting and adolescent resiliency strengthening may be beneficial in this population. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Psychological and physical intimate partner violence and young children's mental health: The role of maternal posttraumatic stress symptoms and parenting behaviors.

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Greene, Carolyn A; Chan, Grace; McCarthy, Kimberly J; Wakschlag, Lauren S; Briggs-Gowan, Margaret J

2018-03-01

Young children are at significant risk of exposure to intimate partner violence (IPV), and vulnerable to exposure-related psychopathology, yet few studies investigate the effects of exposure to IPV on children under the age of 5 years. The current study investigated the role of maternal PTSD symptoms and parenting strategies in the relationship between mothers' IPV experiences and psychopathology in their young children, ages 3-6 years in a community-based cohort of 308 mother-child dyads at high risk for family violence. Data were collected from 2011 to 2014. IPV history and maternal PTSD symptoms were assessed by self-report questionnaires. Children's symptoms were assessed with a developmentally-sensitive psychiatric interview administered to mothers. Punitive/restrictive parenting was independently-coded from in-depth interviews with mothers about their disciplinary practices. Hypothesized direct and indirect pathways between physical and psychological IPV, maternal PTSD, maternal parenting style, and children's internalizing and externalizing symptoms were examined with mediation models. Results indicated that neither physical nor psychological IPV experienced by mothers was directly associated with children's symptoms. However, both types of victimization were associated with maternal PTSD symptoms. Examination of indirect pathways suggested that maternal PTSD symptoms mediated the relationship between mothers' psychological and physical IPV experiences and children's internalizing and externalizing symptoms and mothers' restrictive/punitive parenting mediated the relationship between mothers' psychological IPV and children's externalizing symptoms. In addition, there was a path from maternal physical IPV to child externalizing symptoms through both maternal PTSD symptoms and restrictive/punitive parenting. Findings highlight the importance of supporting parents in recovering from the sequelae of their own traumatic experiences, as their ensuing mental health

Hijab and Depression: Does the Islamic Practice of Veiling Predict Higher Levels of Depressive Symptoms?

Science.gov (United States)

Hodge, David R; Husain, Altaf; Zidan, Tarek

2017-07-01

Hijab or veiling is commonly practiced by Muslim women but remains controversial in the broader secular society. Some Western feminists argue that veiling is an oppressive behavior that negatively affects women by, for example, engendering depression. This article tests this hypothesis with a national sample of American Muslim women (N = 194). The results of the regression analysis did not support the hypothesis. Indeed, women who veiled more frequently reported lower, rather than higher, levels of depressive symptoms. In other words, wearing the hijab appears to be a protective factor in the area of depression. Given the prevalence of depression among women, the results have important implications for practice with Muslim women at both the micro and the macro levels. © 2017 National Association of Social Workers.

External quality assurance agencies and excellence in higher education

Directory of Open Access Journals (Sweden)

Josep Grifoll

2016-07-01

Full Text Available The article presents briefly the complexity of the concept of “excellence” in higher education. Taking into account this reality, the fundamental question is how agencies can consider this complexity in building up criteria on excellence and the use of the concept “excellence” in their improvement strategies and accountability processes in the sector of higher education. Public-private nature of higher education and its growing internationalisation have significant impact on how excellence in education is described and promoted as a tool.

The relations between posttraumatic stress disorder symptoms and disorder of extreme stress (not otherwise specified) symptoms following war captivity.

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Zerach, Gadi; Solomon, Zahava

2013-01-01

War captivity is a recognized pathogenic agent for both posttraumatic stress disorder (PTSD) symptoms and disorder of extreme stress not otherwise specified (DESNOS) symptoms, also known as Complex PTSD. However, the relationship between the two disorders remains unclear. While some scholars assume that the two diagnoses are overlapping and share the same predictors, others believe that the two diagnoses are relatively independent and differ in phenomenology and functional impairment. This study aims to assess both PTSD and DESNOS symptoms and their inter-relations among ex-prisoners of war (ex-POWs) and matched controls, 35 years after the end of the war. The sample included two groups of male Israeli veterans from the 1973 Yom Kippur War: ex-POWs (n = 176) and comparable veterans who had not been held captive (n = 118). PTSD and DESNOS symptoms, battlefield and captivity stressors, and ways of coping in captivity were assessed using self-report questionnaires in 2008. Ex-POWs reported a higher number of PTSD symptoms and higher rates of PTSD symptoms that fill criteria for the diagnosis of PTSD than controls. Furthermore, ex-POWs reported a higher number of DESNOS symptom clusters and higher rates of DESNOS symptoms that fill criteria for the diagnosis of DESNOS. Moreover, we found positive relationships between PTSD symptom clusters and DESNOS symptom clusters. Finally, weight loss and mental suffering in captivity, loss of emotional control and total number of DESNOS symptoms predicted total number of PTSD symptoms. However, only the total number of PTSD symptoms predicted the total number of DESNOS symptoms. This study demonstrated the heavy and extensive toll of war captivity, three decades after the ex-POWs' release from captivity. Importantly, approaching the publication of DSM-5, this study depicts both the high number of DESNOS symptom clusters alongside PTSD symptoms and highlights the complex relationship between the two diagnostic entities. Thus

Forms of Spanking and Children's Externalizing Behaviors

Science.gov (United States)

Lansford, Jennifer E.; Wager, Laura B.; Bates, John E.; Pettit, Gregory S.; Dodge, Kenneth A.

2012-01-01

Research suggests that corporal punishment is related to higher levels of child externalizing behavior, but there has been controversy regarding whether infrequent, mild spanking predicts child externalizing or whether more severe and frequent forms of corporal punishment account for the link. Mothers rated the frequency with which they spanked…

Prevalence of gastro-oesophageal reflux disease symptoms and reflux-associated respiratory symptoms in asthma

Science.gov (United States)

2010-01-01

Background Gastro-oesophageal reflux disease (GORD) symptoms are common in asthma and have been extensively studied, but less so in the Asian continent. Reflux-associated respiratory symptoms (RARS) have, in contrast, been little-studied globally. We report the prevalence of GORD symptoms and RARS in adult asthmatics, and their association with asthma severity and medication use. Methods A cross-sectional analytical study. A validated interviewer-administered GORD scale was used to assess frequency and severity of seven GORD symptoms. Subjects were consecutive asthmatics attending medical clinics. Controls were matched subjects without respiratory symptoms. Results The mean (SD) composite GORD symptom score of asthmatics was significantly higher than controls (21.8 (17.2) versus 12.0 (7.6); P < 0.001) as was frequency of each symptom and RARS. Prevalence of GORD symptoms in asthmatics was 59.4% (95% CI, 59.1%-59.6%) versus 28.5% in controls (95% CI, 29.0% - 29.4%). 36% of asthmatics experienced respiratory symptoms in association with both typical and atypical GORD symptoms, compared to 10% of controls (P < 0.001). An asthmatic had a 3.5 times higher risk of experiencing a GORD symptom after adjusting for confounders (OR 3.5; 95% CI 2.5-5.3). Severity of asthma had a strong dose-response relationship with GORD symptoms. Asthma medication use did not significantly influence the presence of GORD symptoms. Conclusions GORD symptoms and RARS were more prevalent in a cohort of Sri Lankan adult asthmatics compared to non-asthmatics. Increased prevalence of RARS is associated with both typical and atypical symptoms of GORD. Asthma disease and its severity, but not asthma medication, appear to influence presence of GORD symptoms. PMID:20843346

Children with ADHD symptoms have a higher risk for reading, spelling and math difficulties in the GINIplus and LISAplus cohort studies.

Directory of Open Access Journals (Sweden)

Darina Czamara

Full Text Available Attention-deficit/hyperactivity disorder (ADHD and dyslexia belong to the most common neuro-behavioral childhood disorders with prevalences of around 5% in school-aged children. It is estimated that 20-60% of individuals affected with ADHD also present with learning disorders. We investigated the comorbidity between ADHD symptoms and reading/spelling and math difficulties in two on-going population-based birth cohort studies. Children with ADHD symptoms were at significantly higher risk of also showing reading/spelling difficulties or disorder (Odds Ratio (OR = 2.80, p = 6.59×10⁻¹³ as compared to children without ADHD symptoms. For math difficulties the association was similar (OR = 2.55, p = 3.63×10⁻⁰⁴. Our results strengthen the hypothesis that ADHD and learning disorders are comorbid and share, at least partially, the same underlying process. Up to date, it is not clear, on which exact functional processes this comorbidity is based.

Change in depressive symptoms over higher education and professional establishment - a longitudinal investigation in a national cohort of Swedish nursing students.

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Christensson, Anna; Runeson, Bo; Dickman, Paul W; Vaez, Marjan

2010-06-15

There are indications of a high prevalence of psychological distress among students in higher education and also that distress increases over the course of study. However, not all studies on student distress controlled for sociodemographic differences and few followed development of distress over an extended period through professional establishment. We investigated if there is an independent effect of time in education and the first two years in the profession on depressive symptoms and mapped change over the period in a national cohort of students. Data came from LANE, a nation-wide longitudinal panel survey of Swedish nursing students (N = 1700) who responded to annual questionnaires over five years from 2002 to 2007. Depressive symptoms were measured by the Major Depression Inventory and change over time analysed in a linear mixed effects model for repeated measures. There was a significant change in level of depressive symptoms over time: an increase from the first to later years in education and a decrease to levels similar to baseline after graduation and a year in the profession. The change in symptoms remained significant after adjustment for sociodemographic factors (p education and professional establishment on depressive symptoms. We think heightened distress over education abates as the graduate accommodates to the profession. Nevertheless, within education, the differences in depressive symptoms associated to demographic factors can help identify student groups more vulnerable to distress. Also, as individual differences in distress seem to persist over time, perhaps students highly distressed in the beginning of education can be helped by awareness among educators of the elevated levels of distress in late education.

Ball-joint versus single monolateral external fixators for definitive treatment of tibial shaft fractures.

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Beltsios, Michail; Mavrogenis, Andreas F; Savvidou, Olga D; Karamanis, Eirineos; Kokkalis, Zinon T; Papagelopoulos, Panayiotis J

2014-07-01

To compare modular monolateral external fixators with single monolateral external fixators for the treatment of open and complex tibial shaft fractures, to determine the optimal construct for fracture union. A total of 223 tibial shaft fractures in 212 patients were treated with a monolateral external fixator from 2005 to 2011; 112 fractures were treated with a modular external fixator with ball-joints (group A), and 111 fractures were treated with a single external fixator without ball-joints (group B). The mean follow-up was 2.9 years. We retrospectively evaluated the operative time for fracture reduction with the external fixator, pain and range of motion of the knee and ankle joints, time to union, rate of malunion, reoperations and revisions of the external fixators, and complications. The time for fracture reduction was statistically higher in group B; the rate of union was statistically higher in group B; the rate of nonunion was statistically higher in group A; the mean time to union was statistically higher in group A; the rate of reoperations was statistically higher in group A; and the rate of revision of the external fixator was statistically higher in group A. Pain, range of motion of the knee and ankle joints, rates of delayed union, malunion and complications were similar. Although modular external fixators are associated with faster intraoperative fracture reduction with the external fixator, single external fixators are associated with significantly better rates of union and reoperations; the rates of delayed union, malunion and complications are similar.

Children's Exposure to Violence: The Underlying Effect of Posttraumatic Stress Symptoms on Behavior Problems.

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Yoon, Susan; Steigerwald, Stacey; Holmes, Megan R; Perzynski, Adam T

2016-02-01

In this study we investigated whether witnessing violence and violence victimization were associated with children's internalizing and externalizing behavior problems and examined the mediating role of posttraumatic stress (PTS) symptoms in these relationships. Secondary data analysis was conducted using 3 waves of data from the National Survey of Child and Adolescent Well-Being. Path analyses were conducted to test direct and indirect effects of violence exposure on behavior problems, using 2,064 children (ages 8-15 years) reported to Child Protective Services for maltreatment. Being a victim of violence in the home was directly associated with more internalizing (β = .06, p = .007) and externalizing behavior problems (β = .07, p = .002), whereas witnessing violence was not directly related to either internalizing (β = .04, p = .056) or externalizing behavior problems (β = .03, p = .130). PTS symptoms mediated the effects of witnessing violence and violence victimization on internalizing behavior problems (β = .02, p = .002). Our findings suggest that PTS symptoms may be a mechanism underlying the association between violence exposure and internalizing behavior problems (R(2) = .23), underscoring the potential importance of assessing PTS symptoms and providing targeted trauma-focused interventions for children exposed to violence at home. Copyright © 2016 International Society for Traumatic Stress Studies.

Comparative study of attachment relationships in young children with symptoms of externalizing disorders: Attention-deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder and normal children

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Solmaz Najafi Shoar

2016-07-01

Full Text Available This study aimed to compare the relationship of attachment between children with externalizing disorder (ADHD and less conflict and conduct disorder was performed with normal children. And the correlation was causalcomparative research design. The study population included all male students in Year 94 was 12.7 years in Tabriz To this aim, and to a multi-stage random sampling method, a sample of 200 (150 patients with symptoms and 50 normal KCAQ people were selected and CSI-4 was performed on them. The data were analyzed using ANOVA. The results showed that children with externalizing disorders and normal children in terms of attachment there is a significant difference (P <0/005. So that children with attention disorders and children with the disorder more or less active and less conflict in relationships have insecure attachment styles. Another finding of the study showed that children with conduct disorder, avoidant, ambivalent insecure attachment relationships are the common children are secure attachment relationships. Thus, the results of this study have practical implications in clinical areas to the extent that the design of such attachment-based interventions are necessary.

Childhood and current ADHD symptom dimensions are associated with more severe cannabis outcomes in college students.

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Bidwell, L C; Henry, E A; Willcutt, E G; Kinnear, M K; Ito, T A

2014-02-01

Numerous studies have shown that attention deficit/hyperactivity disorder (ADHD) is associated higher risk of cannabis use disorders (CUD). However, these studies are limited in that most did not: (a) differentiate the role of hyperactivity-impulsivity (HI) and inattention (IN); (b) control for associated psychopathology; and (c) consider more fine-grained CUD-related measures. Our aim was to clarify the unique and interactive contributions of inattention and hyperactivity symptoms to age of cannabis initiation and DSM-IV cannabis dependence, craving, and severity of problems related to cannabis use while statistically controlling for symptoms of comorbid psychopathology in a non-clinical sample of young adults. Cannabis variables, current use of cigarettes and alcohol, current and childhood ADHD, and comorbid internalizing and externalizing psychopathology were assessed in 376 male and female undergraduates. Results indicate that current and childhood IN were independently associated with more severe cannabis use, craving, and problem use-related outcomes in young adulthood (p'scannabis (pcannabis use. Associations with ADHD symptom dimensions and current use of alcohol and cigarettes were also present. Thus, current and childhood inattention symptoms as well as childhood hyperactive-impulsive symptoms emerged as significant factors in cannabis-related outcomes in young adults, even after statistically controlling for important confounding variables. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Lower Serum DHEAS levels are associated with a higher degree of physical disability and depressive symptoms in middle-aged to older African American women

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Haren, Matthew T.; Malmstrom, Theodore K.; Banks, William A.; Patrick, Ping; Miller, Douglas K.; Morley, John E.

2007-01-01

Background Changes in androgen levels and associations with chronic disease, physical and neuropsychological function and disability in women over the middle to later years of life are not well understood and have not been extensively studied in African-American women. Aims The present cross-sectional analysis reports such levels and associations in community dwelling, African American women aged 49 – 65 years from St. Louis, Missouri. Methods A home-based physical examination and a health status questionnaire were administered to randomly sampled women. Body composition (DEXA), lower limb and hand-grip muscle strength, physical and neuropsychological function and disability levels were assessed. Blood was drawn and assayed for total testosterone (T), sex hormone-binding globulin (SHBG), dehydroepiandrosterone-sulfate (DHEAS), oestradiol (E2), adiponectin, leptin, triglycerides, glucose, C-reactive protein (CRP) and cytokine receptors (sIL2r, sIL6r, sTNFr1 & sTNFr2). Multiple linear regression modelling was used to identify the best predictors of testosterone, DHEAS and Free Androgen Index (T/SHBG). Results Seventy-four percent of women were menopausal and a quarter of these were taking oestrogen therapy. DHEAS and E2 declined between the ages of 49 and 65 years, whereas total T, SHBG and FAI remained stable. Total T and DHEAS levels were strongly correlated. In this population sample there were no independent associations of either total T or FAI with indicators of functional limitations, disability or clinically relevant depressive symptoms. Unlike total T and FAI, lower DHEAS levels was independently associated with both higher IADL scores (indicating a higher degree of physical disability) and higher CESD scores (indicating a higher degree of clinically relevant depressive symptoms). Conclusion There is an age-related decline in serum DHEAS in African-American women. Lower DHEAS levels appear to be associated with a higher degree of physical disability and

ExternE transport methodology for external cost evaluation of air pollution

DEFF Research Database (Denmark)

Jensen, S. S.; Berkowicz, R.; Brandt, J.

The report describes how the human exposure estimates based on NERI's human exposure modelling system (AirGIS) can improve the Danish data used for exposure factors in the ExternE Transport methodology. Initially, a brief description of the ExternE Tranport methodology is given and it is summarised...

Behavioral Profiles Associated with Objective Sleep Duration in Young Children with Insomnia Symptoms.

Science.gov (United States)

Calhoun, Susan L; Fernandez-Mendoza, Julio; Vgontzas, Alexandros N; Mayes, Susan D; Liao, Duanping; Bixler, Edward O

2017-02-01

Based on previous studies reporting on the association of objective sleep duration and physiologic changes (i.e., increased cortisol) in children, we examined the role of objective sleep duration on differentiating behavioral profiles in children with insomnia symptoms. Seven hundred children (ages 5-12, 47.8% male) from the Penn State Child Cohort underwent a nine-hour polysomnography and parent completed Pediatric Behavior Scale. Insomnia symptoms were defined as parent report of difficulty falling and/or staying asleep, sleep disordered breathing as an AHI of ≥1, and objective short sleep duration as a total sleep time insomnia symptoms demonstrated more overall behavioral problems than controls. Significant interactions between insomnia symptoms and objective sleep duration on scores of externalizing behaviors, mood variability and school problems were found. Profile analyses showed that children with insomnia symptoms and normal sleep duration were associated with clinically elevated externalizing behaviors, inattention, mood variability, and school problems, while children with insomnia and short sleep duration were associated with an overall elevated profile in which internalizing behaviors were more prominent. Childhood insomnia symptoms are associated with a wide array of behavioral problems, for which objective sleep duration is useful in differentiating behavioral profiles. Children with insomnia symptoms and normal sleep duration had a behavioral profile consistent with limit-setting and rule-breaking behaviors, while children with insomnia symptoms and short sleep duration had a behavioral profile more consistent with internalizing behaviors resembling that of psychophysiological disorders.

Combined Influences of Genes, Prenatal Environment, Cortisol, and Parenting on the Development of Children's Internalizing Versus Externalizing Problems.

Science.gov (United States)

Marceau, Kristine; Laurent, Heidemarie K; Neiderhiser, Jenae M; Reiss, David; Shaw, Daniel S; Natsuaki, Misaki N; Fisher, Philip A; Leve, Leslie D

2015-05-01

Research suggests that genetic, prenatal, endocrine, and parenting influences across development individually contribute to internalizing and externalizing problems in children. The present study tests the combined contributions of genetic risk for psychopathology, prenatal environments (maternal drug use and internalizing symptoms), child cortisol at age 4.5 years, and overreactive parenting influences across childhood on 6-year-old children's internalizing and externalizing problems. We used data from an adoption design that included 361 domestically adopted children and their biological and adopted parents prospectively followed from birth. Only parenting influences contributed (independently) to externalizing problems. However, genetic influences were indirectly associated with internalizing problems (through increased prenatal risk and subsequent morning cortisol), and parenting factors were both directly and indirectly associated with internalizing problems (through morning cortisol). Results suggest that prenatal maternal drug use/symptoms and children's morning cortisol levels are mechanisms of genetic and environmental influences on internalizing problems, but not externalizing problems, in childhood.

External Ophthalmomyiasis Caused by Oestrus ovis: A Rare Case Report from India

OpenAIRE

Pandey, Anita; Madan, Molly; Asthana, Ashish K.; Das, Anupam; Kumar, Sandeep; Jain, Kirti

2009-01-01

Myiasis of different organs has been reported off and on from various regions in the world. We report a human case of external ophthalmomyiasis caused by the larvae of a sheep nasal botfly, Oestrus ovis, for the first time from Meerut city in Western Uttar Pradesh, India. A 25-year-old farmer presented with severe symptoms of conjunctivitis. The larvae, 3 in number, were observed in the bulbar conjunctiva, and following removal the symptoms of eye inflammation improved within a few hours.

Parent ratings of ADHD symptoms: differential symptom functioning across Malaysian Malay and Chinese children.

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Gomez, Rapson; Vance, Alasdair

2008-08-01

This study examined differential symptom functioning (DSF) in ADHD symptoms across Malay and Chinese children in Malaysia. Malay (N=571) and Chinese (N=254) parents completed the Disruptive Behavior Rating Scale, which lists the DSM-IV ADHD symptoms. DSF was examined using the multiple indicators multiple causes (MIMIC) structural equation modeling procedure. Although DSF was found for a single inattention (IA) symptom and three hyperactivity-impulsivity (HI) symptoms, all these differences had low effect sizes. Controlling for these DSF, Chinese children had higher IA and HI latent factor scores. However the effect sizes were small. Together, these findings suggest adequate support for invariance of the ADHD symptoms across these ethno-cultural groups. The implications of the findings for cross-cultural invariance of the ADHD symptoms are discussed.

Child Temperamental Flexibility Moderates the Relation between Positive Parenting and Adolescent Adjustment

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Rabinowitz, Jill A.; Drabick, Deborah A.G.; Reynolds, Maureen D.; Clark, Duncan B.; Olino, Thomas M.

2016-01-01

Temperamental flexibility and lower positive parenting are associated with internalizing and externalizing problems; however, youth varying in flexibility may be differentially affected by positive parenting in the prediction of symptoms. We examined whether children's flexibility moderated prospective relations between maternal and paternal positive parenting and youth internalizing and externalizing symptoms during adolescence. Participants (N =775, 71% male) and their caregivers completed measures when youth were 10-12 and 12-14 years old. Father positive parenting interacted with child flexibility to predict father-reported internalizing and externalizing problems. Consistent with the diathesis-stress model, children lower in flexibility experienced greater symptoms than children higher in flexibility in lower positive parenting contexts. Among children lower in flexibility, lower paternal positive parenting was associated with greater internalizing and externalizing symptoms compared to higher paternal positive parenting. However, among youth higher in flexibility, symptom levels were similar regardless of whether youth experienced lower or higher paternal positive parenting. PMID:26834305

Depressive symptoms over higher education and the first years in the profession : a longitudinal investigation in Swedish nursing students

OpenAIRE

Christensson, Anna

2011-01-01

Background and aims: A substantial part of the population attends higher education, which makes the welfare of students a matter of concern for public health. There are indications of a high prevalence of mental distress and depressive symptoms in students, as well as an increase over the past decades. If this is an effect of education, the demographic composition of student groups or changes in mental health at the societal level is uncertain. The overall objectives of this thesis were to in...

Pathways from maternal distress and child problem behavior to adolescent depressive symptoms: a prospective examination from early childhood to adolescence.

Science.gov (United States)

Nilsen, Wendy; Gustavson, Kristin; Røysamb, Espen; Kjeldsen, Anne; Karevold, Evalill

2013-06-01

The main aim of this study was to identify the pathways from maternal distress and child problem behaviors (i.e., internalizing and externalizing problems) across childhood and their impact on depressive symptoms during adolescence among girls and boys. Data from families of 921 Norwegian children in a 15-year longitudinal community sample were used. Using structural equation modeling, the authors explored the interplay between maternal-reported distress and child problem behaviors measured at 5 time points from early (ages 1.5, 2.5, and 4.5 years) and middle (age 8.5 years) childhood to early adolescence (age 12.5 years), and their prediction of self-reported depressive symptoms during adolescence (ages 14.5 and 16.5 years). The findings revealed paths from internalizing and externalizing problems throughout the development for corresponding problems (homotypic paths) and paths from early externalizing to subsequent internalizing problems (heterotypic paths). The findings suggest 2 pathways linking maternal-rated risk factors to self-reported adolescent depressive symptoms. There was a direct path from early externalizing problems to depressive symptoms. There was an indirect path from early maternal distress going through child problem behavior to depressive symptoms. In general, girls and boys were similar, but some gender-specific effects appeared. Problem behaviors in middle childhood had heterotypic paths to subsequent problems only for girls. The findings highlight the developmental importance of child externalizing problems, as well as the impact of maternal distress as early as age 1.5 years for the development of adolescent depressive symptoms. Findings also indicate a certain vulnerable period in middle childhood for girls. NOTE: See Supplemental Digital Content 1, at http://links.lww.com/JDBP/A45, for a video introduction to this article.

One-year follow-up of a parent management training for children with externalizing behaviour problems in the real world.

Science.gov (United States)

Hautmann, Christopher; Hoijtink, Herbert; Eichelberger, Ilka; Hanisch, Charlotte; Plück, Julia; Walter, Daniel; Döpfner, Manfred

2009-07-01

The long-term effectiveness of parent training for children with externalizing behaviour problems under routine care within the German health care system is unclear. We report the 1-year follow-up results of the parent training component of the Prevention Program for Externalizing Problem Behaviour (PEP) for 270 children aged 3-10 years with externalizing behaviour problems. Outcome measures included child behaviour problems (externalizing behaviour problems, Attention-Deficit/Hyperactivity Disorder symptoms and Oppositional Defiant Disorder symptoms) and parenting (self efficacy of parenting and perceived ability to solve difficult parenting situations). Data were analysed using multilevel modelling. Comparison of the changes during the 3-month waiting and treatment periods revealed significantly stronger treatment effects on all outcome measures, indicating a substantial decrease in child behaviour problems and a significant increase in parenting due to treatment. At 1-year follow-up, initial treatment effects on child behaviour problems were maintained, while parenting continued to improve. Families whose children exhibited externalizing problem behaviour profit from PEP and improvements are maintained for at least one year.

Symptom and performance validity with veterans assessed for attention-deficit/hyperactivity disorder (ADHD).

Science.gov (United States)

Shura, Robert D; Denning, John H; Miskey, Holly M; Rowland, Jared A

2017-12-01

Little is known about attention-deficit/hyperactivity disorder (ADHD) in veterans. Practice standards recommend the use of both symptom and performance validity measures in any assessment, and there are salient external incentives associated with ADHD evaluation (stimulant medication access and academic accommodations). The purpose of this study was to evaluate symptom and performance validity measures in a clinical sample of veterans presenting for specialty ADHD evaluation. Patients without a history of a neurocognitive disorder and for whom data were available on all measures (n = 114) completed a clinical interview structured on DSM-5 ADHD symptoms, the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF), and the Test of Memory Malingering Trial 1 (TOMM1) as part of a standardized ADHD diagnostic evaluation. Veterans meeting criteria for ADHD were not more likely to overreport symptoms on the MMPI-2-RF nor to fail TOMM1 (score ≤ 41) compared with those who did not meet criteria. Those who overreported symptoms did not endorse significantly more ADHD symptoms; however, those who failed TOMM1 did report significantly more ADHD symptoms (g = 0.90). In the total sample, 19.3% failed TOMM1, 44.7% overreported on the MMPI-2-RF, and 8.8% produced both an overreported MMPI-2-RF and invalid TOMM1. F-r had the highest correlation to TOMM1 scores (r = -.30). These results underscore the importance of assessing both symptom and performance validity in a clinical ADHD evaluation with veterans. In contrast to certain other conditions (e.g., mild traumatic brain injury), ADHD as a diagnosis is not related to higher rates of invalid report/performance in veterans. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Adaptation to high current using low external resistances eliminates power overshoot in microbial fuel cells

KAUST Repository

Hong, Yiying; Call, Douglas F.; Werner, Craig M.; Logan, Bruce E.

2011-01-01

. Acclimation of the high external resistance reactors for a few cycles to low external resistance (5. Ω), and therefore higher current densities, eliminated power overshoot. MFCs initially acclimated to low external resistances exhibited both higher current

Symptoms and fungi associated with esca in South African vineyards

Directory of Open Access Journals (Sweden)

Chana-LEE WHITE

2011-12-01

Full Text Available In the past, only a few incidences of esca diseased grapevines were reported from the Slanghoekand Rawsonville areas of South Africa, with the damage believed to be of little importance so that the diseasehas not been studied in South Africa. In the present study, vines with internal or external symptoms of the esca disease complex were sampled from table, raisin and wine grape cultivars from 37 production areas inthe Western Cape, Northern Cape and Limpopo provinces of that country. Most vines were greater than 10years old, but younger vines (3 and 5 years old were also found to be infected. External symptoms, includingdieback, tiger striped leaves, berry symptoms (shrivelling, insufficient colouring and apoplexy, resembledthose found on grapevines in Europe and the USA, although the typical tiger stripe symptom was observedless frequently. The internal stem and trunk symptoms were similar to European symptoms, and includedwhite rot, black and brown wood streaking, brown necrosis within white rot, sectorial brown necrosis andbrown/red/margins next to decay, which often included back lines delimiting white decay. The fungi isolatedmostly from the white rot were basidiomycetes species (30.4%. Black and brown wood streaking was primarily caused by Phaeomoniella chlamydospora (45.4%. Brown necrosis within the white rot was linked to colonization by basidiomycetes (20.4%, Phaeoacremonium aleophilum (15.9% and Pa. chlamydospora (13.6%. Phaeomoniella chlamydospora (20.8% and Botryosphaeriaceae species (10.7% were isolated the most fromthe sectorial brown necrosis and Pa. chlamydospora (29.1% from the brown/red margins and black lines next to decay. Given the wide distribution of esca complex wood and foliar symptoms in the grape growing regions investigated, this disease should be considered as an important limiting factor in the productive lifespan of vineyards and the quality of produce from grapevine in South Africa.

A higher score on the Aging Males' Symptoms scale is associated with insulin resistance in middle-aged men.

Science.gov (United States)

Hamanoue, Nobuya; Tanabe, Makito; Tanaka, Tomoko; Akehi, Yuko; Murakami, Junji; Nomiyama, Takashi; Yanase, Toshihiko

2017-05-30

An age-associated androgen decrease and its pathological conditions are defined as late-onset hypogonadism (LOH). Among the various symptoms associated with LOH, a visceral fat increase is strongly associated with relatively low levels of testosterone. However, few studies have investigated the relationship between the Aging Males' Symptoms (AMS) scores and metabolic abnormalities. Thus, we aimed to clarify this relationship by investigating the relationship between AMS scores and various markers in blood. During routine health examinations in 241 middle-aged males (52.7±7.5 years of age, mean±SD), 150 males (62.2%) displayed higher AMS values than normal. No statistical association was observed between total AMS scores and any testosterone value. All mental, physical and sexual AMS subscales were significantly positively correlated with insulin levels and HOMA-IR. Only sexual subscale scores were significantly inversely associated with free or bioavailable testosterone level. Males with insulin resistance (HOMA-IR≥2.5) demonstrated significantly higher AMS scores than those with normal insulin sensitivity (HOMA-IRinsulin and HOMA-IR values. Interestingly, univariate and multivariate analyses revealed that HOMA-IR≥2.5 was a significant predictor for detection of moderately severe AMS values (AMS≥37), whereas AMS≥37 was not a predictor of metabolic syndrome by International Diabetes Federation (IDF) criterion. In conclusion, almost 60% of healthy male subjects displayed abnormal AMS scores. AMS values were not associated with testosterone values but rather were related to insulin resistance, particularly in subjects with moderately severe AMS values. Insulin resistance-related general unwellness might be reflected by AMS values.

Assessing the underlying dimensionality of DSM-5 PTSD symptoms in Chinese adolescents surviving the 2008 Wenchuan earthquake.

Science.gov (United States)

Wang, Li; Zhang, Lingmin; Armour, Cherie; Cao, Chengqi; Qing, Yulan; Zhang, Jianxin; Liu, Ping; Zhang, Biao; Wu, Qi; Zhao, Zhihong; Fan, Gaolin

2015-04-01

By analyzing data yielded from a sample of Chinese adolescents surviving a high-intensity earthquake, this study investigated the underlying dimensionality of DSM-5 PTSD symptoms. The sample included 743 traumatized middle school students (396 females and 332 males) aged 11-17 years (mean=13.6, SD=1.0). Results of confirmatory factor analysis showed that an intercorrelated seven-factor model comprised of intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal factors provided a significant better representation of DSM-5 PTSD symptoms than other alternative models. Further analyses indicated that external measures of major depression disorder and panic disorder symptoms displayed unique associations with four PTSD factors. The findings provide further support for the newly proposed seven-factor model of DSM-5 PTSD symptoms, add to very limited empirical knowledge on the latent structure of DSM-5 PTSD symptoms among adolescents, and carry implications for further refinement of the current classifications of PTSD symptoms and further clinical practice and research on posttraumatic stress symptomatology. Copyright © 2015 Elsevier Ltd. All rights reserved.

External Ophthalmomyiasis Caused by Oestrus ovis: A Rare Case Report from India

Science.gov (United States)

Madan, Molly; Asthana, Ashish K.; Das, Anupam; Kumar, Sandeep; Jain, Kirti

2009-01-01

Myiasis of different organs has been reported off and on from various regions in the world. We report a human case of external ophthalmomyiasis caused by the larvae of a sheep nasal botfly, Oestrus ovis, for the first time from Meerut city in Western Uttar Pradesh, India. A 25-year-old farmer presented with severe symptoms of conjunctivitis. The larvae, 3 in number, were observed in the bulbar conjunctiva, and following removal the symptoms of eye inflammation improved within a few hours. PMID:19290093

Remission of Maternal Depression: Relations to Family Functioning and Youth Internalizing and Externalizing Symptoms

Science.gov (United States)

Foster, Cynthia Ewell; Webster, Melissa C.; Weissman, Myrna M.; Pilowsky, Daniel J.; Wickramaratne, Priya J.; Talati, Ardesheer; Rush, A. John; Hughes, Carroll W.; Garber, Judy; Malloy, Erin; Cerda, Gabrielle; Kornstein, Susan G.; Alpert, Jonathan E.; Wisniewski, Stephen R.; Trivedi, Madhukar H.; Fava, Maurizio; King, Cheryl A.

2009-01-01

Family functioning and parenting were hypothesized to mediate the relation between remission of maternal depression and children's psychosocial adjustment. Participants were 114 mother-child dyads participating in the Sequenced Treatment Alternatives to Relieve Depression Child 3-month follow-up. All mothers had been diagnosed with major depressive disorder and were treated initially with citalopram; 33% of mothers experienced remission of depressive symptoms. Youth ranged in age from 7 to 17. Remission of maternal depression was associated with changes in children's reports of their mothers' warmth/acceptance, which in turn partially mediated the relation between maternal depression remission and youth internalizing symptoms, accounting for 22.9% of the variance. PMID:18991123

Combined influences of genes, prenatal environment, cortisol, and parenting on the development of children’s internalizing vs. externalizing problems

Science.gov (United States)

Marceau, Kristine; Laurent, Heidemarie K.; Neiderhiser, Jenae M.; Reiss, David; Shaw, Daniel S.; Natsuaki, Misaki; Fisher, Philip A.; Leve, Leslie D.

2014-01-01

Research suggests that genetic, prenatal, endocrine, and parenting influences across development individually contribute to internalizing and externalizing problems in children. The present study tests the combined contributions of genetic risk for psychopathology, prenatal environments (maternal drug use and internalizing symptoms), child cortisol at age 4.5 years, and overreactive parenting influences across childhood on 6-year-old children’s internalizing and externalizing problems. We used data from an adoption design that included 361 domestically adopted children and their biological and adopted parents prospectively followed from birth. Only parenting influences contributed (independently) to externalizing problems. However, genetic influences were indirectly associated with internalizing problems (through increased prenatal risk and subsequent morning cortisol), and parenting factors were both directly and indirectly associated with internalizing problems (through morning cortisol). Results suggest that prenatal maternal drug use/symptoms and children’s morning cortisol levels are mechanisms of genetic and environmental influences on internalizing problems, but not externalizing problems, in childhood. PMID:25355319

Externalities of energy. Swedish implementation of the ExternE methodology

International Nuclear Information System (INIS)

Nilsson, Maans; Gullberg, M.

1998-01-01

The growing interest for developing economic instruments for efficient environmental policies has opened up a large area of multi-disciplinary research. ExternE is an example of this research, combining disciplines such as engineering, ecology, immunology and economics expertise to create new knowledge about how environmental pressures from energy production affect our nature and society. The ExternE Project aims to identify and, as far as possible quantify the externalities of energy production in Europe. The Stockholm Environment Institute has carried out a preliminary aggregation: -Coal Fuel Cycle: centred around Vaesteraas Kraftvaermeverk, Vaesteraas. This is the largest co-generation plant in Sweden, with four blocks and a maximum co-generation output of 520 MW electricity and 950 MW heat. The analysis is carried out on boiler B4. -Biomass Fuel Cycle: centred around Haendeloeverket, Norrkoeping. This plant predominately burns forestry residues, but a variety of fuels are combusted. Haendeloeverket has an installed capacity of 100 MW electricity and 375 MW heat, in a total of three boilers and two back-pressure turbines. The analysis is carried out on boiler P13. -Hydro Fuel Cycle: Klippens Kraftstation, Storuman. Built in 1990-1994, it is the youngest hydro power station in Sweden. It has been designed and built with significant efforts to account for and protect environmental values. Installed capacity is 28 MW. The environmental impact assessment from the construction of this plant is carried out, but the evaluation is still not finalized. The preliminary aggregation aimed to test whether ExternE results could be used to make estimates for the entire Swedish electricity production system. Hence, national results as well as results from other partner countries in ExternE has been applied

Adolescent attachment, family functioning and depressive symptoms

Directory of Open Access Journals (Sweden)

Nishola Rawatlal

2015-08-01

Full Text Available Background. Adolescence represents a challenging transitional period where changes in biological, emotional, cognitive and social domains can increase the risk of developing internalised problems including subthreshold depression. Adolescent-parent attachment style, perceived support and family functioning may increase risk for depressive symptoms or may reduce such risk. Adolescent-parent attachment, adolescent-perceived support from parents and family functioning were examined as correlates of depressive symptom presentation within this age group. Methods. Participants included a maternal parent and an adolescent (65.5% female from each family. Adolescents were in Grade 7 (n=175 or Grade 10 (n=31. Data were collected through home interviews. The Self-Report of Family Inventory (SFI, Experiences of Close Relationships Scale (ECR, Network of Relationships Inventory (NRI, Children’s Depression Inventory (CDI and Child Behavior Checklist (CBCL were used to assess depression, parental support and attachment.  Results. Two models were examined: one with adolescent report of depressive symptoms as the outcome and a second with parent report of adolescent internalising symptoms as the outcome. The model predicting adolescent-reported depressive symptoms was significant with older age, higher levels of avoidant attachment, and higher levels of youth-reported dysfunctional family interaction associated with more depressive symptomatology. In the model predicting parent report of adolescent internalising symptoms only higher levels of dysfunctional family interaction, as reported by the parent, were associated with higher levels of internalising symptoms. Conclusion. Positive family communication, cohesion and support predictive of a secure parent-adolescent attachment relationship reduced the risk of a depressive symptom outcome. Secure adolescents were able to regulate their emotions, knowing that they could seek out secure base attachment relations

Enhancing the stepped solar still performance using internal and external reflectors

International Nuclear Information System (INIS)

Omara, Z.M.; Kabeel, A.E.; Younes, M.M.

2014-01-01

Highlights: • Stepped solar still with internal and external reflectors have been investigated. • The productivity of the modified stepped solar still is higher than conventional by 103%. • The productivity of stepped still with external mirror is higher than that for conventional still by 88%. - Abstract: The performance of stepped solar still with internal and external reflectors have been investigated in the current study. The reflectors are used to enhance energy input to the stepped still. The influence of internal and external (top and bottom) reflectors on the performance of the stepped solar still is investigated. A comparison between modified stepped solar still and conventional solar still is carried out to evaluate the developed desalination system performance under the same climate conditions. The results indicated that, during experimentation the productivity of the modified stepped solar still with internal and external (top and bottom) reflectors is higher than that for conventional still approximately by 125%. In this case the estimated cost of 1 l of distillate for stepped still with reflectors and conventional solar stills is approximately 0.031$ and 0.049$, respectively

Parenting in the Wake of Abuse: Exploring the Mediating Role of PTSD Symptoms on the Relationship Between Parenting and Child Functioning.

Science.gov (United States)

Symes, Lene; McFarlane, Judith; Fredland, Nina; Maddoux, John; Zhou, Weiden

2016-02-01

Children whose mothers report partner violence and symptoms of posttraumatic stress disorder (PTSD) are at risk for behavior dysfunctions. To examine the mediating effects of maternal PTSD symptoms on the relationship of parenting behaviors to child internalizing and externalizing behavior dysfunctions. Maternal PTSD symptoms have a partial mediating effect on the relationship between inconsistent discipline and child internalizing and externalizing behaviors. Maternal PTSD symptoms have a fully mediating effect on the relationship between poor supervision and child internalizing behaviors. There is a need to identify women who report partner violence and are at high risk for PTSD and intervene early to prevent problematic parenting and resulting child behavior problems. Copyright © 2015 Elsevier Inc. All rights reserved.

Environmental external effects from wind power based on the EU ExternE methodology

DEFF Research Database (Denmark)

Ibsen, Liselotte Schleisner; Nielsen, Per Sieverts

1998-01-01

of the Danish part of the project is to implement the framework for externality evaluation, for three different power plants located in Denmark. The paper will focus on the assessment of the impacts of the whole fuel cycles for wind, natural gas and biogas. Priority areas for environmental impact assessment......The European Commission has launched a major study project, ExternE, to develop a methodology to quantify externalities. A “National Implementation Phase”, was started under the Joule II programme with the purpose of implementing the ExternE methodology in all member states. The main objective...

The lure of the symptom in psychoanalytic treatment.

Science.gov (United States)

Ogden, Thomas H; Gabbard, Glen O

2010-06-01

Psychoanalysis, which at its core is a search for truth, stands in a subversive position vis-à-vis the contemporary therapeutic culture that places a premium on symptomatic "cure." Nevertheless, analysts are vulnerable to succumbing to the internal and external pressures for the achievement of symptomatic improvement. In this communication we trace the evolution of Freud's thinking about the relationship between the aims of psychoanalysis and the alleviation of symptoms. We note that analysts today may recapitulate Freud's early struggles in their pursuit of symptom removal. We present an account of a clinical consultation in which the analytic pair were ensnared in an impasse that involved the analyst's preoccupation with the intransigence of one of the patient's symptoms. We suggest alternative ways of working with these clinical issues and offer some thoughts on how our own work as analysts and consultants to colleagues has been influenced by our understanding of what frequently occurs when the analyst becomes symptom-focused.

ExternE National Implementation Finland

Energy Technology Data Exchange (ETDEWEB)

Pingoud, K; Maelkki, H; Wihersaari, M; Pirilae, P [VTT Energy, Espoo (Finland); Hongisto, M [Imatran Voima Oy, Vantaa (Finland); Siitonen, S [Ekono Energy Ltd, Espoo (Finland); Johansson, M [Finnish Environment Institute, Helsinki (Finland)

1999-07-01

ExternE National Implementation is a continuation of the ExternE Project, funded in part by the European Commission's Joule III Programme. This study is the result of the ExternE National Implementation Project for Finland. Three fuel cycles were selected for the Finnish study: coal, peat and wood-derived biomass, which together are responsible for about 40% of total electricity generation in Finland and about 75% of the non-nuclear fuel based generation. The estimated external costs or damages were dominated by the global warming (GW) impacts in the coal and peat fuel cycles, but knowledge of the true GW impacts is still uncertain. From among other impacts that were valued in monetary terms the human health damages due to airborne emissions dominated in all the three fuel cycles. Monetary valuation for ecosystem impacts is not possible using the ExternE methodology at present. The Meri-Pori power station representing the coal fuel cycle is one of the world's cleanest and most efficient coal-fired power plants with a condensing turbine. The coal is imported mainly from Poland. The estimated health damages were about 4 mECU/kWh, crop damages an order of magnitude lower and damages caused to building materials two orders of magnitude lower. The power stations of the peat and biomass fuel cycles are of CHP type, generating electricity and heat for the district heating systems of two cities. Their fuels are of domestic origin. The estimated health damages allocated to electricity generation were about 5 and 6 mECU/kWh, respectively. The estimates were case-specific and thus an generalisation of the results to the whole electricity generation in Finland is unrealistic. Despite the uncertainties and limitations of the methodology, it is a promising tool in the comparison of similar kinds of fuel cycles, new power plants and pollution abatement technologies and different plant locations with each other. (orig.)

ExternE National Implementation Finland

Energy Technology Data Exchange (ETDEWEB)

Pingoud, K.; Maelkki, H.; Wihersaari, M.; Pirilae, P. [VTT Energy, Espoo (Finland); Hongisto, M. [Imatran Voima Oy, Vantaa (Finland); Siitonen, S. [Ekono Energy Ltd, Espoo (Finland); Johansson, M. [Finnish Environment Institute, Helsinki (Finland)

1999-07-01

ExternE National Implementation is a continuation of the ExternE Project, funded in part by the European Commission's Joule III Programme. This study is the result of the ExternE National Implementation Project for Finland. Three fuel cycles were selected for the Finnish study: coal, peat and wood-derived biomass, which together are responsible for about 40% of total electricity generation in Finland and about 75% of the non-nuclear fuel based generation. The estimated external costs or damages were dominated by the global warming (GW) impacts in the coal and peat fuel cycles, but knowledge of the true GW impacts is still uncertain. From among other impacts that were valued in monetary terms the human health damages due to airborne emissions dominated in all the three fuel cycles. Monetary valuation for ecosystem impacts is not possible using the ExternE methodology at present. The Meri-Pori power station representing the coal fuel cycle is one of the world's cleanest and most efficient coal-fired power plants with a condensing turbine. The coal is imported mainly from Poland. The estimated health damages were about 4 mECU/kWh, crop damages an order of magnitude lower and damages caused to building materials two orders of magnitude lower. The power stations of the peat and biomass fuel cycles are of CHP type, generating electricity and heat for the district heating systems of two cities. Their fuels are of domestic origin. The estimated health damages allocated to electricity generation were about 5 and 6 mECU/kWh, respectively. The estimates were case-specific and thus an generalisation of the results to the whole electricity generation in Finland is unrealistic. Despite the uncertainties and limitations of the methodology, it is a promising tool in the comparison of similar kinds of fuel cycles, new power plants and pollution abatement technologies and different plant locations with each other. (orig.)

ExternE National Implementation Finland

International Nuclear Information System (INIS)

Pingoud, K.; Maelkki, H.; Wihersaari, M.; Pirilae, P.; Hongisto, M.; Siitonen, S.; Johansson, M.

1999-01-01

ExternE National Implementation is a continuation of the ExternE Project, funded in part by the European Commission's Joule III Programme. This study is the result of the ExternE National Implementation Project for Finland. Three fuel cycles were selected for the Finnish study: coal, peat and wood-derived biomass, which together are responsible for about 40% of total electricity generation in Finland and about 75% of the non-nuclear fuel based generation. The estimated external costs or damages were dominated by the global warming (GW) impacts in the coal and peat fuel cycles, but knowledge of the true GW impacts is still uncertain. From among other impacts that were valued in monetary terms the human health damages due to airborne emissions dominated in all the three fuel cycles. Monetary valuation for ecosystem impacts is not possible using the ExternE methodology at present. The Meri-Pori power station representing the coal fuel cycle is one of the world's cleanest and most efficient coal-fired power plants with a condensing turbine. The coal is imported mainly from Poland. The estimated health damages were about 4 mECU/kWh, crop damages an order of magnitude lower and damages caused to building materials two orders of magnitude lower. The power stations of the peat and biomass fuel cycles are of CHP type, generating electricity and heat for the district heating systems of two cities. Their fuels are of domestic origin. The estimated health damages allocated to electricity generation were about 5 and 6 mECU/kWh, respectively. The estimates were case-specific and thus an generalisation of the results to the whole electricity generation in Finland is unrealistic. Despite the uncertainties and limitations of the methodology, it is a promising tool in the comparison of similar kinds of fuel cycles, new power plants and pollution abatement technologies and different plant locations with each other. (orig.)

Temperament, Character, and Adolescents' Depressive Symptoms: Focusing on Affect

Directory of Open Access Journals (Sweden)

Danilo Garcia

2012-01-01

Full Text Available Positive (PA and negative affect (NA are two separate systems markers of subjective well-being and measures of the state depression (low PA combined with high NA. The present study investigated differences in temperament, character, locus of control, and depressive symptoms (sleep quality, stress, and lack of energy between affective profiles in an adolescent sample. Participants (=304 were categorized into four affective profiles: “self-fulfilling” (high PA, low NA, “high affective” (high PA, high NA, “low affective” (low PA, low NA, and “self-destructive” (low PA, high NA. Personality was measured by the Temperament and Character Inventory and affective profiles by the Positive Affect and Negative Affect Schedule. The “self-fulfilling” profile was characterized by, compared to the other affective profiles, higher levels of sleep quality, less stress and more energy and also higher levels of persistence and a mature character (i.e., high scores in self-directedness and cooperativeness. “Self-destructive” adolescents reported higher levels of external locus of control, high scores in harm avoidance and reward dependence combined with less mature character. The results identify the importance of character maturity in well-being and suggest that depressive state can be positively influenced by promoting positive emotions which appears to be achieved by character development.

Differential risk for late adolescent conduct problems and mood dysregulation among children with early externalizing behavior problems.

Science.gov (United States)

Okado, Yuko; Bierman, Karen L

2015-05-01

To investigate the differential emergence of antisocial behaviors and mood dysregulation among children with externalizing problems, the present study prospectively followed 317 high-risk children with early externalizing problems from school entry (ages 5-7) to late adolescence (ages 17-19). Latent class analysis conducted on their conduct and mood symptoms in late adolescence revealed three distinct patterns of symptoms, characterized by: 1) criminal offenses, conduct disorder symptoms, and elevated anger ("conduct problems"), 2) elevated anger, dysphoric mood, and suicidal ideation ("mood dysregulation"), and 3) low levels of severe conduct and mood symptoms. A diathesis-stress model predicting the first two outcomes was tested. Elevated overt aggression at school entry uniquely predicted conduct problems in late adolescence, whereas elevated emotion dysregulation at school entry uniquely predicted mood dysregulation in late adolescence. Experiences of low parental warmth and peer rejection in middle childhood moderated the link between early emotion dysregulation and later mood dysregulation but did not moderate the link between early overt aggression and later conduct problems. Thus, among children with early externalizing behavior problems, increased risk for later antisocial behavior or mood dysfunction may be identifiable in early childhood based on levels of overt aggression and emotion dysregulation. For children with early emotion dysregulation, however, increased risk for mood dysregulation characterized by anger, dysphoric mood, and suicidality--possibly indicative of disruptive mood dysregulation disorder--emerges only in the presence of low parental warmth and/or peer rejection during middle childhood.

Symptoms after hospital discharge following hematopoietic stem cell transplantation

Directory of Open Access Journals (Sweden)

Gamze Oguz

2014-01-01

Full Text Available Aims: The purposes of this study were to assess the symptoms of hematopoietic stem cell transplant patients after hospital discharge, and to determine the needs of transplant patients for symptom management. Materials and Methods: The study adopted a descriptive design. The study sample comprised of 66 hematopoietic stem cell transplant patients. The study was conducted in Istanbul. Data were collected using Patient Information Form and Memorial Symptom Assessment Scale (MSAS. Results: The frequency of psychological symptoms in hematopoietic stem cell transplant patients after discharge period (PSYCH subscale score 2.11 (standard deviation (SD = 0.69, range: 0.93-3.80 was higher in hematopoietic stem cell transplant patients than frequency of physical symptoms (PHYS subscale score: 1.59 (SD = 0.49, range: 1.00-3.38. Symptom distress caused by psychological and physical symptoms were at moderate level (Mean = 1.91, SD = 0.60, range: 0.95-3.63 and most distressing symptoms were problems with sexual interest or activity, difficulty sleeping, and diarrhea. Patients who did not have an additional chronic disease obtained higher MSAS scores. University graduates obtained higher Global Distress Index (GDI subscale and total MSAS scores with comparison to primary school graduates. Total MSAS, MSAS-PHYS subscale, and MSAS-PSYCH subscale scores were higher in patients with low level of income (P < 0.05. The patients (98.5% reported to receive education about symptom management after hospital discharge. Conclusions: Hematopoietic stem cell transplant patients continue to experience many distressing physical or psychological symptoms after discharge and need to be supported and educated for the symptom management.

In patient's with Parkinson disease, autonomic symptoms are frequent and associated with other non-motor symptoms.

Science.gov (United States)

Arnao, Valentina; Cinturino, Antonio; Valentino, Francesca; Perini, Valentina; Mastrilli, Sergio; Bellavia, Gabriele; Savettieri, Giovanni; Realmuto, Sabrina; D'Amelio, Marco

2015-10-01

Autonomic symptoms and sleep disorders are common non-motor symptoms of Parkinson disease (PD), which are correlated with poor quality of life for patients. To assess the frequency of autonomic symptoms in a consecutive series of PD patients and to correlate them with other motor and non-motor symptoms. All consecutive non-demented PD patients who underwent an extensive evaluation including Hoehn and Yahr staging, Unified Parkinson's Disease Rating Scale, Beck's Depression Inventory, Neuropsychiatric Inventory, PDQ-39 Scale, the Parkinson's diseases Sleep Scale, the Epworth Sleepiness Scale and SCOPA-AUT scale were enrolled. Comorbidity has been also considered. Supine to standing position blood pressure and cardiac frequency changes were also measured. 135 PD patients were included (mean age at interview 67.7; mean disease duration: 5.3 years). Patients were stratified according to mean SCOPA-AUT scale score (13.1). Those with higher SCOPA-AUT scale score were significantly older, had longer disease duration, worse disease stage, worse quality of sleep, were more severely affected, and were also taking a higher dosage of levodopa. At multivariate analysis, older age, longer disease duration, and worse quality of sleep were independently associated with higher SCOPA-AUT scale scores. Our results remark the role of autonomic symptoms in PD. In our patient population, characterized by mild to moderate disease severity, most of the patients complained of autonomic nervous system involvement (84%). A significant association between autonomic symptoms and sleep disorders was also observed.

Regional Externalities

NARCIS (Netherlands)

Heijman, W.J.M.

2007-01-01

The book offers practical and theoretical insights in regional externalities. Regional externalities are a specific subset of externalities that can be defined as externalities where space plays a dominant role. This class of externalities can be divided into three categories: (1) externalities

Changing Boundaries in Israeli Higher Education.

Science.gov (United States)

Guri-Rosenblit, Sarah

1999-01-01

Analyzes changes that have occurred in Israeli's higher education system over the decades, accounting for the reconstruction of its external and internal boundaries. Provides a conceptual framework for comparing national higher education systems. Examines developments characterizing the restructuring of Israeli higher education from a…

Externalities - an analysis using the EU ExternE-results

International Nuclear Information System (INIS)

2003-10-01

The EU project ExternE quantified the externalities for the different energy technologies. In this work, the ExternE results are used in a MARKAL-analysis for the Nordic countries. The analysis does not go into detail, but gives some interesting indications: The external costs are not fully covered in the Nordic energy systems, the present taxes and charges are not high enough. The emissions from the energy systems would be strongly reduced, if taxes/environmental charges were set at the level ExternE calculate. The emissions from power production would be reduced most. Renewable energy sources and natural gas dominate the energy systems in the ExternE case

Unintentional Injuries in Preschool Age Children: Is There a Correlation With Parenting Style and Parental Attention Deficit and Hyperactivity Symptoms.

Science.gov (United States)

Acar, Ethem; Dursun, Onur Burak; Esin, İbrahim Selcuk; Öğütlü, Hakan; Özcan, Halil; Mutlu, Murat

2015-08-01

Unintentional injuries are the leading cause of death among children. Previous research has shown that most of the injuries occur in and around the home. Therefore, parents have a key role in the occurrence and prevention of injuries. In this study, we examined the relationship among home injuries to children and parental attention deficit hyperactivity disorder (ADHD) symptoms, parental attitudes, and children's behavioral problems.Forty children who were admitted to the emergency department because of home injuries constitute the study group. The control group also consisted of 40 children, who were admitted for mild throat infections. The parents filled out questionnaires assessing parental ADHD, child behavioral problems, and parenting attitudes.Scores were significantly higher for both internalizing disorders and externalizing disorders in study groups. We also found that ADHD symptoms were significantly higher among fathers of injured children compared with fathers of control groups. Democratic parenting was also found to correlate with higher numbers of injuries.Parenting style, as well as the psychopathology of both the parents and children, is important factors in children's injuries. A child psychiatrist visit following an emergency procedure may help to prevent further unintentional injuries to the child.

ExternE: Externalities of energy Vol. 1. Summary

International Nuclear Information System (INIS)

Holland, M.; Berry, J.

1995-01-01

There is a growing requirement for policy analysts to take account of the environment in their decision making and to undertake the specified cost-benefit analysis. Within the European Union this is reflected in the 5th Environmental Action Programme, and the Commission's White Paper entitled 'Growth, competitiveness, employment and the ways forward to the 21st century'. This has led to a need for evaluation of environmental externalities. The ExternE Project commenced in 1991 as the European part of a collaborative study between the European Commission and the US Department of Energy. It aims to be the first systematic approach to the evaluation of external costs of a wide range of different fuel cycles. The project will result in an operational accounting framework for the quantification and monetarisation of priority environmental and other externalities. This framework will allow the calculation of the marginal external costs and benefits for specific power plants, at specific sites using specified technologies. There are three major phases in the project. Phase 1 was undertaken in collaboration with the US Department of Energy. In this phase the teams jointly developed the conceptual approach and methodology and shared scientific information for application to a number of fuel cycles. On the European side work concentrated on the nuclear and coal fuel cycles which together were expected to raise many of the fundamental issues in fuel cycle analysis. The project is currently nearing completion of Phase 2. During this phase the methodology has been applied to a wide range of different fossil, nuclear and renewable fuel cycles for power generation and energy conservation options. Also a series of National Implementation Programmes is underway in which the methodology and accounting framework are being applied to reference sites throughout Europe. In addition the general methodology is being extended to address the evaluation of externalities associated with

ExternE: Externalities of energy Vol. 2. Methodology

International Nuclear Information System (INIS)

Berry, J.; Holland, M.; Watkiss, P.

1995-01-01

This report describes the methodology used by the ExternE Project of the European Commission (DGXII) JOULE Programme for assessment of the external costs of energy. It is one of a series of reports describing analysis of nuclear, fossil and renewable fuel cycles for assessment of the externalities associated with electricity generation. Part I of the report deals with analysis of impacts, and Part II with the economic valuation of those impacts. Analysis is conducted on a marginal basis, to allow the effect of an incremental investment in a given technology to be quantified. Attention has been paid to the specificity of results with respect to the location of fuel cycle activities, the precise technologies used, and the type and source of fuel. The main advantages of this detailed approach are as follows: It takes full and proper account of the variability of impacts that might result from different power projects; It is more transparent than analysis based on hypothetically 'representative' cases for each of the different fuel cycles; It provides a framework for consistent comparison between fuel cycles. A wide variety of impacts have been considered. These include the effects of air pollution on the natural and human environment, consequences of accidents in the workplace, impacts of noise and visual intrusion on amenity, and the effects of climate change arising from the release of greenhouse gases. Wherever possible we have used the 'impact pathway' or 'damage function' approach to follow the analysis from identification of burdens (e.g. emissions) through to impact assessment and then valuation in monetary terms. This has required a detailed knowledge of the technologies involved, pollutant dispersion, analysis of effects on human and environmental health, and economics. In view of this the project brought together a multi-disciplinary team with experts from many European countries and the USA. The spatial and temporal ranges considered in the analysis are

Do Executive and Reactive Disinhibition Mediate the Effects of Familial Substance Use Disorders on Adolescent Externalizing Outcomes?

Science.gov (United States)

Handley, Elizabeth D.; Chassin, Laurie; Haller, Moira M.; Bountress, Kaitlin E.; Dandreaux, Danielle; Beltran, Iris

2011-01-01

The present study examined the potential mediating roles of executive and reactive disinhibition in predicting conduct problems, ADHD symptoms, and substance use among adolescents with and without a family history of substance use disorders. Using data from 247 high-risk adolescents, parents, and grandparents, structural equation modeling indicated that reactive disinhibition, as measured by sensation seeking, mediated the effect of familial drug use disorders on all facets of the adolescent externalizing spectrum. Executive disinhibition, as measured by response disinhibition, spatial short term memory, and “trait” impulsivity, was associated with ADHD symptoms. Moreover, although executive functioning weakness were unrelated to familial substance use disorders, adolescents with familial alcohol use disorders were at risk for “trait” impulsivity marked by a lack of planning. These results illustrate the importance of “unpacking” the broad temperament style of disinhibition and of studying the processes that underlie the commonality among facets of the externalizing spectrum and processes that that predict specific externalizing outcomes. PMID:21668077

External costs of nuclear: Greater or less than the alternatives?

International Nuclear Information System (INIS)

Rabl, Ari; Rabl, Veronika A.

2013-01-01

Since Fukushima many are calling for a shutdown of nuclear power plants. To see whether such a shutdown would reduce the risks for health and environment, the external costs of nuclear electricity are compared with alternatives that could replace it. The frequency of catastrophic nuclear accidents is based on the historical record, about one in 25 years for the plants built to date, an order of magnitude higher than the safety goals of the U.S. Nuclear Regulatory Commission. Impacts similar to Chernobyl and Fukushima are assumed to estimate the cost. A detailed comparison is presented with wind as alternative with the lowest external cost. The variability of wind necessitates augmentation by other sources, primarily fossil fuels, because storage at the required scale is in most regions too expensive. The external costs of natural gas combined cycle are taken as 0.6 €cent/kWh due to health effects of air pollution and 1.25 €cent/kWh due to greenhouse gases (at 25€/t CO 2 eq ) for the central estimate, but a wide range of different parameters is also considered, both for nuclear and for the alternatives. Although the central estimate of external costs of the wind-based alternative is higher than that of nuclear, the uncertainty ranges overlap. - Highlights: ► The external costs of nuclear electricity are compared with the alternatives. ► Frequency and cost of nuclear accidents based on Chernobyl and Fukushima. ► Detailed comparison with wind as alternative with the lowest external costs. ► High external cost of wind because of natural gas backup (storage too limited). ► External costs of wind higher than nuclear but uncertainty ranges overlap

Maternal Warmth and Early Adolescents' Internalizing Symptoms and Externalizing Behavior: Mediation via Emotional Insecurity

Science.gov (United States)

Alegre, Albert; Benson, Mark J.; Pérez-Escoda, Núria

2014-01-01

This study examines the relation between maternal warmth and the internalizing and externalizing problems of early adolescents, and the potential mediation of this relation by emotional insecurity. The hypotheses for the study derive from Cummings and Davies' theory of emotional security. The current study extends the theory to security processes…

Attention deficit/hyperactivity disorder symptoms moderate cognition and behavior in children with autism spectrum disorders.

Science.gov (United States)

Yerys, Benjamin E; Wallace, Gregory L; Sokoloff, Jennifer L; Shook, Devon A; James, Joette D; Kenworthy, Lauren

2009-12-01

Recent estimates suggest that 31% of children with autism spectrum disorders (ASD) meet diagnostic criteria for attention deficit/hyperactivity disorder (ADHD), and another 24% of children with ASD exhibit subthreshold clinical ADHD symptoms. Presence of ADHD symptoms in the context of ASD could have a variety of effects on cognition, autistic traits, and adaptive/maladaptive behaviors including: exacerbating core ASD impairments; adding unique impairments specific to ADHD; producing new problems unreported in ASD or ADHD; having no clear impact; or producing some combination of these scenarios. Children with ASD and co-morbid ADHD symptoms (ASD+ADHD; n = 21), children with ASD without ADHD (ASD; n = 28), and a typically developing control group (n = 21) were included in the study; all groups were matched on age, gender-ratio, IQ, and socioeconomic status. Data were collected on verbal and spatial working memory, response inhibition, global executive control (EC), autistic traits, adaptive functioning, and maladaptive behavior problems. In this sample, the presence of ADHD symptoms in ASD exacerbated impairments in EC and adaptive behavior and resulted in higher autistic trait, and externalizing behavior ratings. ADHD symptoms were also associated with greater impairments on a lab measure of verbal working memory. These findings suggest that children with ASD+ADHD symptoms present with exacerbated impairments in some but not all domains of functioning relative to children with ASD, most notably in adaptive behavior and working memory. Therefore, ADHD may moderate the expression of components of the ASD cognitive and behavioral phenotype, but ASD+ADHD may not represent an etiologically distinct phenotype from ASD alone.

Antisocial peer affiliation and externalizing disorders: Evidence for Gene × Environment × Development interaction.

Science.gov (United States)

Samek, Diana R; Hicks, Brian M; Keyes, Margaret A; Iacono, William G; McGue, Matt

2017-02-01

Gene × Environment interaction contributes to externalizing disorders in childhood and adolescence, but little is known about whether such effects are long lasting or present in adulthood. We examined gene-environment interplay in the concurrent and prospective associations between antisocial peer affiliation and externalizing disorders (antisocial behavior and substance use disorders) at ages 17, 20, 24, and 29. The sample included 1,382 same-sex twin pairs participating in the Minnesota Twin Family Study. We detected a Gene × Environment interaction at age 17, such that additive genetic influences on antisocial behavior and substance use disorders were greater in the context of greater antisocial peer affiliation. This Gene × Environment interaction was not present for antisocial behavior symptoms after age 17, but it was for substance use disorder symptoms through age 29 (though effect sizes were largest at age 17). The results suggest adolescence is a critical period for the development of externalizing disorders wherein exposure to greater environmental adversity is associated with a greater expression of genetic risk. This form of Gene × Environment interaction may persist through young adulthood for substance use disorders, but it appears to be limited to adolescence for antisocial behavior.

Antisocial Peer Affiliation and Externalizing Disorders: Evidence for Gene × Environment × Development Interaction

Science.gov (United States)

Samek, Diana R.; Hicks, Brian M.; Keyes, Margaret A.; Iacono, William G.; McGue, Matt

2016-01-01

Gene × environment interaction contributes to externalizing disorders in adolescence, but little is known about whether such effects are long-lasting or present in adulthood. We examined gene-environment interplay in the concurrent and prospective associations between antisocial peer affiliation and externalizing disorders (antisocial behavior and substance use disorders) at ages 17, 20, 24, and 29. The sample included 1,382 same-sex twin pairs participating in the Minnesota Twin Family Study. We detected a gene × environment interaction at age 17, such that additive genetic influences on antisocial behavior and substance use disorders were greater in the context of greater antisocial peer affiliation. This gene × environment interaction was not present for antisocial behavior symptoms after age 17, but was for substance use disorder symptoms through age 29 (though effect sizes were largest at age 17). Results suggest adolescence is a critical period for the development of externalizing disorders wherein exposure to greater environmental adversity is associated with a greater expression of genetic risk. This form of gene × environment interaction may persist through young adulthood for substance use disorders, but is limited to adolescence for antisocial behavior. PMID:27580681

Self- and other-agency in people with passivity (first rank) symptoms in schizophrenia.

Science.gov (United States)

Graham-Schmidt, Kyran T; Martin-Iverson, Mathew T; Waters, Flavie A V

2018-02-01

Individuals with passivity (first-rank) symptoms report that their actions, thoughts and sensations are influenced or controlled by an external (non-self) agent. Passivity symptoms are closely linked to schizophrenia and related disorders yet they remain poorly understood. One dominant framework posits a role for deficits in the sense of agency. An important question is whether deficits in self-agency can be differentiated from other-agency in schizophrenia and passivity symptoms. This study aimed to evaluate self- and other-agency in 51 people with schizophrenia (n=20 current, 10 past, 21 no history of passivity symptoms), and 48 healthy controls. Participants completed the projected hand illusion (PHI) with active and passive movements, as well as immediate and delayed visual feedback. Experiences of agency and loss of agency over the participant's hand and the image ('the other hand') were assessed with a self-report questionnaire. Those with passivity symptoms (current and past) reported less difference in agency between active and passive movements on items assessing agency over their own hand (but not agency over the other hand). Relative to the healthy controls, the current and never groups continued to experience the illusion with delayed visual feedback suggesting impaired timing mechanisms regardless of symptom profile. These findings are consistent with a reduced contribution of proprioceptive predictive cues to agency judgements specific to self representations in people with passivity symptoms, and a subsequent reliance on external visual cues in these judgements. Altogether, these findings emphasise the multifactorial nature of agency and the contribution of multiple impairments to passivity symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.

Prevalence of gastro-oesophageal reflux disease symptoms and reflux-associated respiratory symptoms in asthma

Directory of Open Access Journals (Sweden)

de Silva H Janaka

2010-09-01

Full Text Available Abstract Background Gastro-oesophageal reflux disease (GORD symptoms are common in asthma and have been extensively studied, but less so in the Asian continent. Reflux-associated respiratory symptoms (RARS have, in contrast, been little-studied globally. We report the prevalence of GORD symptoms and RARS in adult asthmatics, and their association with asthma severity and medication use. Methods A cross-sectional analytical study. A validated interviewer-administered GORD scale was used to assess frequency and severity of seven GORD symptoms. Subjects were consecutive asthmatics attending medical clinics. Controls were matched subjects without respiratory symptoms. Results The mean (SD composite GORD symptom score of asthmatics was significantly higher than controls (21.8 (17.2 versus 12.0 (7.6; P P Conclusions GORD symptoms and RARS were more prevalent in a cohort of Sri Lankan adult asthmatics compared to non-asthmatics. Increased prevalence of RARS is associated with both typical and atypical symptoms of GORD. Asthma disease and its severity, but not asthma medication, appear to influence presence of GORD symptoms.

External costs related to power production technologies. ExternE national implementation for Denmark

Energy Technology Data Exchange (ETDEWEB)

Schleisner, L; Sieverts Nielsen, P [eds.

1997-12-01

The objective of the ExternE National Implementation project has been to establish a comprehensive and comparable set of data on externalities of power generation for all EU member states and Norway. The tasks include the application of the ExternE methodology to the most important fuel cycles for each country as well as to update the already existing results, to aggregate these site- and technology-specific results to more general figures. The current report covers the detailed information concerning the ExternE methodology. Importance is attached to the computer system used in the project and the assessment of air pollution effects on health, materials and ecological effects. Also the assessment of global warming damages are described. Finally the report covers the detailed information concerning the national implementation for Denmark for an offshore wind farm and a wind farm on land, a decentralised CHP plant based on natural gas and a decentralised CHP plant base on biogas. (au) EU-JOULE 3. 79 tabs., 11 ills., 201 refs.

External costs related to power production technologies. ExternE national implementation for Denmark

International Nuclear Information System (INIS)

Schleisner, L.; Sieverts Nielsen, P.

1997-12-01

The objective of the ExternE National Implementation project has been to establish a comprehensive and comparable set of data on externalities of power generation for all EU member states and Norway. The tasks include the application of the ExternE methodology to the most important fuel cycles for each country as well as to update the already existing results, to aggregate these site- and technology-specific results to more general figures. The current report covers the detailed information concerning the ExternE methodology. Importance is attached to the computer system used in the project and the assessment of air pollution effects on health, materials and ecological effects. Also the assessment of global warming damages are described. Finally the report covers the detailed information concerning the national implementation for Denmark for an offshore wind farm and a wind farm on land, a decentralised CHP plant based on natural gas and a decentralised CHP plant base on biogas. (au) EU-JOULE 3. 79 tabs., 11 ills., 201 refs

Genetic and Environmental Associations Between Procrastination and Internalizing/Externalizing Psychopathology.

Science.gov (United States)

Gustavson, Daniel E; du Pont, Alta; Hatoum, Alexander S; Hyun Rhee, Soo; Kremen, William S; Hewitt, John K; Friedman, Naomi P

2017-09-01

Recent work on procrastination has begun to unravel the genetic and environmental correlates of this problematic behavior. However, little is known about how strongly procrastination is associated with internalizing and externalizing psychopathology, and the extent to which shared genetic/environmental factors or relevant personality constructs (e.g., fear of failure, impulsivity, and neuroticism) can inform the structure of these associations. The current study examined data from 764 young adult twins who completed questionnaires assessing procrastination and personality and structured interviews regarding psychopathology symptoms. Results indicated that procrastination was positively correlated with both internalizing and externalizing latent variables, and that these correlations were driven by shared genetic influences. Moreover, the association between procrastination and internalizing was accounted for by fear of failure and neuroticism, whereas the association between procrastination and externalizing was primarily explained by impulsivity. The role of procrastination in psychopathology is discussed using a framework that highlights common and broadband-specific variance.

Prevalence of menopausal symptoms in Asian midlife women: a systematic review.

Science.gov (United States)

Islam, M Rakibul; Gartoulla, P; Bell, R J; Fradkin, P; Davis, S R

2015-04-01

To systematically review published articles for the prevalence of menopausal symptoms in Asian women. A comprehensive and systematic literature search was performed using MEDLINE, EMBASE, PsycINFO, CINAHL, SCOPUS and Google scholar in June 2013 to retrieve all English-language studies that included information on the prevalence of menopausal symptoms in women living in Asian countries. Risk of bias of included studies was assessed using a risk-of-bias tool explicitly designed for the systematic review of prevalence studies. Twenty-three independent studies met our inclusion criteria. Physical symptoms were the most prevalent symptoms compared to psychological, vasomotor and sexual symptoms. There was a wide variation in the prevalence of all symptoms across the menopausal stages due to the differences in modes of recruitment, study design, sampling procedures, the time frame over which symptoms were assessed and use of different diagnostic or screening tools. A high level of bias was observed for both external and internal validity for most studies. Although there is a wide variation in the reported prevalence of menopausal symptoms, physical symptoms predominate, followed by psychological symptoms, vasomotor symptoms and sexual symptoms. Further studies of representative samples are necessary to understand whether the variations in prevalence reporting are a function of methodological issues or due to ethnic, cultural or other socioeconomic differences.

Unlocking higher harmonics in atomic force microscopy with gentle interactions.

Science.gov (United States)

Santos, Sergio; Barcons, Victor; Font, Josep; Verdaguer, Albert

2014-01-01

In dynamic atomic force microscopy, nanoscale properties are encoded in the higher harmonics. Nevertheless, when gentle interactions and minimal invasiveness are required, these harmonics are typically undetectable. Here, we propose to externally drive an arbitrary number of exact higher harmonics above the noise level. In this way, multiple contrast channels that are sensitive to compositional variations are made accessible. Numerical integration of the equation of motion shows that the external introduction of exact harmonic frequencies does not compromise the fundamental frequency. Thermal fluctuations are also considered within the detection bandwidth of interest and discussed in terms of higher-harmonic phase contrast in the presence and absence of an external excitation of higher harmonics. Higher harmonic phase shifts further provide the means to directly decouple the true topography from that induced by compositional heterogeneity.

Nuclear medicine external individual occupational doses in Rio de Janeiro

International Nuclear Information System (INIS)

Mauricio, Claudia L.P.; Lima, Ana Luiza S.; Silva, Herica L.R. da; Santos, Denison Souza; Silva, Claudio Ribeiro da

2009-01-01

According to the Brazilian National Database there are about 300 Nuclear Medicine Services (NMS) in Brazil, 44 of them located in the State of Rio de Janeiro (RJ). Individual dose measurements are an important input for the evaluation of occupational exposure in order to demonstrate the effectiveness of radioprotection implementation and to keep individual doses as low as possible. In Brazil, most nuclear medicine (NM) staff is routinely monitored for external dose. The internal committed dose is estimated only in abnormal conditions. This paper makes a statistics analysis of all the RJ NMS annual external occupational doses in year 2005. A study of the evolution of monthly external individual doses higher than 4.00 mSv from 2004 to 2008 is also presented. The number of registered thorax monthly dose higher than 4.0 mSv is increasing, as its value. In this period the highest dose measured reaches 56.9 mSv, in one month, in 2008. About 50% of the annual doses are smaller than the monthly record level of 0.20 mSv. In 2005, around 100 professionals of RJ NMS received annual doses higher than 4.0 mSv, considering only external doses, but no one receives doses higher than 20.0 mSv. Extremities dosimeters are used by about 15% of the staff. In some cases, these doses are more than 10 times higher than the dose in thorax. This study shows the importance to improve radiation protection procedures in NM. (author)

Eating disorder symptoms and parenting styles.

Science.gov (United States)

Haycraft, Emma; Blissett, Jackie

2010-02-01

This study aimed to examine associations between symptoms of eating disorders and parenting style, in a non-clinical sample. One hundred and five mothers completed self-report measures of eating disorder symptoms and parenting style. Higher levels of eating disorder symptoms were associated with more authoritarian and permissive parenting styles. Authoritative parenting was not significantly related to eating disorder symptoms. The findings demonstrate that eating disorder symptoms in non-clinical individuals are related to less adaptive parenting styles. These findings have potential implications for clinicians working with mothers with eating disorders. 2009 Elsevier Ltd. All rights reserved.

Idiopathic Bilateral External Jugular Vein Thrombosis.

Science.gov (United States)

Hindi, Zakaria; Fadhel, Ehab

2015-08-20

Vein thrombosis is mainly determined by 3 factors, which constitute a triad called Virchow's triad: hypercoagulability, stasis, and endothelial injury. Venous thrombosis commonly occurs in the lower extremities since most of the blood resides there and flows against gravity. The veins of the lower extremities are dependent on intact valves and fully functional leg muscles. However, in case of valvular incompetency or muscular weakness, thrombosis and blood stasis will occur as a result. In contrast, the veins of the neck, specially the jugulars, have distensible walls which allow flexibility during respiration. In addition, the blood directly flows downward towards the heart. Nevertheless, many case reports mentioned the thrombosis of internal jugular veins and external jugular veins with identified risk factors. Jugular vein thrombosis has previously been associated in the literature with a variety of medical conditions, including malignancy. This report is of a case of idiopathic bilateral external jugular vein thrombosis in a 21 year-old male construction worker of Southeast Asian origin with no previous medical history who presented with bilateral facial puffiness of gradual onset over 1 month. Doppler ultrasound and computed tomography were used in the diagnosis. Further work-up showed no evidence of infection or neoplasia. The patient was eventually discharged on warfarin. The patient was assessed after 6 months and his symptoms had resolved completely. Bilateral idiopathic external jugular veins thrombosis is extremely rare and can be an indicator of early malignancy or hidden infection. While previous reports in the literature have associated jugular vein thrombosis with malignancy, the present case shows that external jugular vein thrombosis can also be found in persons without malignancy.

Adaptation to high current using low external resistances eliminates power overshoot in microbial fuel cells

KAUST Repository

Hong, Yiying

2011-10-01

One form of power overshoot commonly observed with mixed culture microbial fuel cells (MFCs) is doubling back of the power density curve at higher current densities, but the reasons for this type of overshoot have not been well explored. To investigate this, MFCs were acclimated to different external resistances, producing a range of anode potentials and current densities. Power overshoot was observed for reactors acclimated to higher (500 and 5000. Ω) but not lower (5 and 50. Ω) resistances. Acclimation of the high external resistance reactors for a few cycles to low external resistance (5. Ω), and therefore higher current densities, eliminated power overshoot. MFCs initially acclimated to low external resistances exhibited both higher current in cyclic voltammograms (CVs) and higher levels of redox activity over a broader range of anode potentials (-0.4 to 0. V; vs. a Ag/AgCl electrode) based on first derivative cyclic voltammetry (DCV) plots. Reactors acclimated to higher external resistances produced lower current in CVs, exhibited lower redox activity over a narrower anode potential range (-0.4 to -0.2. V vs. Ag/AgCl), and failed to produce higher currents above ∼-0.3. V (vs. Ag/AgCl). After the higher resistance reactors were acclimated to the lowest resistance they also exhibited similar CV and DCV profiles. Our findings show that to avoid overshoot, prior to the polarization and power density tests the anode biofilm must adapt to low external resistances to be capable of higher currents. © 2011 Elsevier B.V.

The interplay of externalizing problems and physical and inductive discipline during childhood.

Science.gov (United States)

Choe, Daniel Ewon; Olson, Sheryl L; Sameroff, Arnold J

2013-11-01

Children who are physically disciplined are at elevated risk for externalizing problems. Conversely, maternal reasoning and reminding of rules, or inductive discipline, is associated with fewer child externalizing problems. Few studies have simultaneously examined bidirectional associations between these forms of discipline and child adjustment using cross-informant, multimethod data. We hypothesized that less inductive and more physical discipline would predict more externalizing problems, children would have evocative effects on parenting, and high levels of either form of discipline would predict low levels of the other. In a study of 241 children-spanning ages 3, 5.5, and 10-structural equation modeling indicated that 3-year-olds with higher teacher ratings of externalizing problems received higher mother ratings of physical discipline at age 5.5. Mothers endorsing more inductive discipline at child age 3 reported less physical discipline and had children with fewer externalizing problems at age 5.5. Negative bidirectional associations emerged between physical and inductive discipline from ages 5.5 to 10. Findings suggested children's externalizing problems elicited physical discipline, and maternal inductive discipline might help prevent externalizing problems and physical discipline.

The influence of personality, measured by the Karolinska Scales of Personality (KSP), on symptoms among subjects in suspected sick buildings.

Science.gov (United States)

Runeson, R; Norbäck, D; Klinteberg, B; Edling, C

2004-12-01

The aim was to study possible relationships between personality traits as measured by the Karolinska Scales of Personality (KSP), a self-report personality inventory based on psychobiological theory, and medical symptoms, in subjects with previous work history in suspected sick buildings. The study comprised 195 participants from 19 consecutive cases of suspected sick buildings, initially collected in 1988-92. In 1998-89, the KSP inventory and a symptoms questionnaire were administered in a postal follow-up study. There were 16 questions on symptoms, including symptoms from the eyes, nose, throat, skin, and headache, tiredness, and a symptom score (SC), ranging from 0 to 16, was calculated. The questionnaire also requested information on personal factors, including age, gender, smoking habits, allergy and diagnosed asthma. The KSP ratings in the study group did not differ from the mean personality scale norm scores, calculated from an external reference group. Females had higher scores for somatic anxiety (P < 0.01), muscular tension (P < 0.001), psychic anxiety (P < 0.01), psychasthenia (P < 0.05), indirect aggression (P < 0.05), and guilt (P < 0.05), while males scored higher on detachment (P < 0.001). Subjects with higher SC were found to display higher degree of somatic anxiety (P < 0.001), muscular tension (P < 0.001), psychic anxiety (P < 0.001), psychasthenia (P < 0.001), inhibition of aggression (P < 0.05), detachment (P < 0.05), suspicion (P < 0.01), indirect aggression (P < 0.01), and verbal aggression (P < 0.05). In addition, ocular, respiratory, dermal, and systemic symptoms (headache and tiredness) were significantly related to anxiety- and aggressivity-related scales. There were associations between personality scales and change of symptom score (SC) during the 9-year period. The associations between KSP personality traits and symptoms were more pronounced in females. In conclusion, there are gender differences in personality and SBS symptoms

Externalities of fuel cycles 'ExternE' project. Summary report

International Nuclear Information System (INIS)

Holland, M.; Berry, J.

1994-01-01

There is a growing requirement for policy analysts to take account of the environment in their decision making and to undertake the specified cost-benefit analysis. Within the European Union this is reflected in the 5th Environmental Action Programme, and the Commission's White Paper entitled 'Growth, competitiveness, employment and the ways forward to the 21st century'. This has led to a need for evaluation of environmental externalities. The ExternE Project commenced in 1991 as the European part of a collaborative study between the European Commission and the US Department of Energy. It aims to be the first systematic approach to the evaluation of external costs of a wide range of different fuel cycles. The project will result in an operational accounting framework for the quantification and monetarisation of priority environmental and other externalities. This framework will allow the calculation of the marginal external costs and benefits for specific power plants, at specific sites using specified technologies. There are three major phases in the project. Phase I was undertaken in collaboration with the US Department of Energy. In this phase the teams jointly developed the conceptual approach and methodology and shared scientific information for application to a number of fuel cycles. On the European side work concentrated on the nuclear and coal fuel cycles which together were expected to raise many of the fundamental issues in fuel cycle analysis. The project is currently nearing completion of Phase 2. During this phase the methodology has been applied to a wide range of different fossil, nuclear and renewable fuel cycles for power generation and energy conservation options. Also a series of National Implementation Programmes are underway in which the methodology and accounting framework are being applied to reference sites throughout Europe. In addition the general methodology is being extended to address the evaluation of externalities associated with

Down the slippery slop: Utility incorporation of environmental externalities

International Nuclear Information System (INIS)

Vandenberg, A.J.; Tempchin, R.S.; Mitnick, S.A.; Harron, A.L.

1993-01-01

Advocates of incorporating environmental externalities in electric utility decision-making have concentrated on new electric generating resources, with some success. Such public utility commission actions compel utilities to consider, explicitly, the cost of sulfur dioxide, carbon dioxide, nitrogen oxides and other emission of power-plants when comparing the economics of new generating resources with those of other resource options (e.g., demand-side management and gas-fired non-utility generator projects). This paper summarizes a study which estimated costs of incorporating externalities in utility system operations. We also present an analysis of the Tellus work in this area, and contrast Tellus' methodology, assumptions and results with our own. Estimates of the cost of incorporating externalities in system operations is rather large, in terms of the increased fuel and purchased power cost that ratepayers would have to bear. For the eight cases we examined, the incorporation of externalities caused fuel and purchased power cost to be 9.3 to 69.5 percent higher, relative to what it would have been under traditional generating unit commitment and dispatch. Furthermore, we believe that these estimates of fuel and purchased power cost increases are conservative. In particular, because our analyses focused on utility system operations in 1995, the key assumption about the fuel cost differential (i.e., coal versus natural gas) probably underestimates the differential in later years, significantly, when virtually all forecasters foresee faster cost escalation rates for gas. In general, the higher the fuel cost differential, the faster cost escalation rates for gas. In general, the higher the fuel cost differential, the greater the cost of an externality policy. Unless the record is set straight soon, the idea that incorporating externalities is virtually costless will further spread in the regulatory community and among government policy-makers

Higher Education Leadership Graduate Program Development

Science.gov (United States)

Freeman, Sydney, Jr.; Chambers, Crystal Renée; Newton, Rochelle

2016-01-01

Graduate programs in higher education administration and leadership have sought to equip students with the knowledge, skills, and competencies for higher education leadership; that is, to prepare globally minded leaders who can navigate the internal and external demands of, and for, higher education. With the use of the Lattuca and Stark model of…

Dimensional structure of DSM-5 posttraumatic stress disorder symptoms: results from the National Health and Resilience in Veterans Study.

Science.gov (United States)

Tsai, Jack; Harpaz-Rotem, Ilan; Armour, Cherie; Southwick, Steven M; Krystal, John H; Pietrzak, Robert H

2015-05-01

To evaluate the prevalence of DSM-5 posttraumatic stress disorder (PTSD) and factor structure of PTSD symptomatology in a nationally representative sample of US veterans and examine how PTSD symptom clusters are related to depression, anxiety, suicidal ideation, hostility, physical and mental health-related functioning, and quality of life. Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative survey of 1,484 US veterans conducted from September through October 2013. Confirmatory factor analyses were conducted to evaluate the factor structure of PTSD symptoms, and structural equation models were constructed to examine the association between PTSD symptom clusters and external correlates. 12.0% of veterans screened positive for lifetime PTSD and 5.2% for past-month PTSD. A 5-factor dysphoric arousal model and a newly proposed 6-factor model both fit the data significantly better than the 4-factor model of DSM-5. The 6-factor model fit the data best in the full sample, as well as in subsamples of female veterans and veterans with lifetime PTSD. The emotional numbing symptom cluster was more strongly related to depression (P < .001) and worse mental health-related functioning (P < .001) than other symptom clusters, while the externalizing behavior symptom cluster was more strongly related to hostility (P < .001). A total of 5.2% of US veterans screened positive for past-month DSM-5 PTSD. A 6-factor model of DSM-5 PTSD symptoms, which builds on extant models and includes a sixth externalizing behavior factor, provides the best dimensional representation of DSM-5 PTSD symptom clusters and demonstrates validity in assessing health outcomes of interest in this population. © Copyright 2015 Physicians Postgraduate Press, Inc.

The mediational role of parenting on the longitudinal relation between child personality and externalizing behavior.

Science.gov (United States)

Prinzie, Peter; van der Sluis, Cathy M; de Haan, Amaranta D; Deković, Maja

2010-08-01

Building on prior cross-sectional work, this longitudinal study evaluated the proposition that maternal and paternal overreactive and authoritative parenting mediates the effect of child personality characteristics on externalizing behavior. Data from the Flemish Study on Parenting, Personality, and Problem Behavior were used in a moderated mediation analysis (N=434). Teachers rated children's Big Five characteristics, fathers and mothers rated their parenting, and 3 years later, children rated their externalizing behavior. Mediational analysis revealed both direct and indirect effects. Higher levels of Extraversion and lower levels of Benevolence were related directly to higher levels of child externalizing behavior. Higher levels of paternal authoritative parenting and lower levels of maternal overreactivity were related to lower scores on externalizing behavior. In addition, the relation between Benevolence, Emotional Stability, and externalizing behavior was partially mediated by parental overreactivity. Conscientiousness had an indirect effect on externalizing behavior through paternal authoritative parenting. Relations were not moderated by child gender. This study is of theoretical interest because the results demonstrate that parenting is a mediating mechanism that accounts for associations between personality and externalizing behavior.

Brief Report: Social Skills, Internalizing and Externalizing Symptoms, and Respiratory Sinus Arrhythmia in Autism

Science.gov (United States)

Neuhaus, Emily; Bernier, Raphael; Beauchaine, Theodore P.

2014-01-01

Theoretical and empirical models describe respiratory sinus arrhythmia (RSA) as a peripheral biomarker of emotion regulation and social competence. Recent findings also link RSA to individual differences in social functioning within autism spectrum disorder (ASD). However, associations between RSA and symptoms of internalizing/externalizing…

Sexual Orientation and Depressive Symptoms in Adolescents.

Science.gov (United States)

Luk, Jeremy W; Gilman, Stephen E; Haynie, Denise L; Simons-Morton, Bruce G

2018-05-01

Sexual orientation disparities in adolescent depressive symptoms are well established, but reasons for these disparities are less well understood. We modeled sexual orientation disparities in depressive symptoms from late adolescence into young adulthood and evaluated family satisfaction, peer support, cyberbullying victimization, and unmet medical needs as potential mediators. Data were from waves 2 to 6 of the NEXT Generation Health Study ( n = 2396), a population-based cohort of US adolescents. We used latent growth models to examine sexual orientation disparities in depressive symptoms in participants aged 17 to 21 years, conduct mediation analyses, and examine sex differences. Relative to heterosexual adolescents, sexual minority adolescents (those who are attracted to the same or both sexes or are questioning; 6.3% of the weighted sample) consistently reported higher depressive symptoms from 11th grade to 3 years after high school. Mediation analyses indicated that sexual minority adolescents reported lower family satisfaction, greater cyberbullying victimization, and increased likelihood of unmet medical needs, all of which were associated with higher depressive symptoms. The mediating role of cyberbullying victimization was more pronounced among male than female participants. Sexual minority adolescents reported higher depressive symptoms than heterosexual adolescents from late adolescence into young adulthood. Collectively, low family satisfaction, cyberbullying victimization, and unmet medical needs accounted for >45% of differences by sexual orientation. Future clinical research is needed to determine if interventions targeting these psychosocial and health care-related factors would reduce sexual orientation disparities in depressive symptoms and the optimal timing of such interventions. Copyright © 2018 by the American Academy of Pediatrics.

Monitoring somatic symptoms in patients with mental disorders: Sensitivity to change and minimal clinically important difference of the Somatic Symptom Scale - 8 (SSS-8).

Science.gov (United States)

Gierk, Benjamin; Kohlmann, Sebastian; Hagemann-Goebel, Marion; Löwe, Bernd; Nestoriuc, Yvonne

2017-09-01

The SSS-8 is a brief questionnaire for the assessment of somatic symptom burden. This study examines its sensitivity to change and the minimal clinically important difference (MCID) in patients with mental disorders. 55 outpatients with mental disorders completed the SSS-8 and measures of anxiety, depression, and disability before and after receiving treatment. Effect sizes and correlations between the change scores were calculated. The MCID was estimated using a one standard error of measurement threshold and the change in disability as an external criterion. There was a medium decline in somatic symptom burden for the complete sample (n=55, d z =0.53) and a large decline in a subgroup with very high somatic symptom burden at baseline (n=11, d z =0.94). Decreases in somatic symptom burden were associated with decreases in anxiety (r=0.68, pSSS-8 is sensitive to change. A 3-point decrease reflects a clinically important improvement. Due to its brevity and sound psychometric properties, the SSS-8 is useful for monitoring somatic symptom burden. Copyright © 2017 Elsevier Inc. All rights reserved.

External costs of energy - do the answers match the questions? Looking back at 10 years of ExternE

International Nuclear Information System (INIS)

Krewitt, W.

2002-01-01

While the claim for 'getting prices right' is quite popular in conceptual policy papers, the implementation of appropriate internalisation strategies is still hampered by a lack of reliable external cost data. Great expectations were set into the ExternE project, a major research programme launched by the European Commission at the beginning of the 1990s to provide a scientific basis for the quantification of energy related externalities and to give guidance supporting the design of internalisation measures. After more than a decade of research, the ExternE label became a well recognised standard source for external cost data. Looking back into the ExternE history, the paper pursues how emerging new scientific insights and changing background assumptions affected external cost estimates and related recommendations to policy over time. Based on ExternE results, the usefulness and inherent limitations of external cost estimates for impact categories like climate change or nuclear waste disposal is discussed. The paper also gives examples on how external costs in spite of remaining uncertainties are successfully used to support environmental policy. (Author)

Understanding the Covariation among Childhood Externalizing Symptoms: Genetic and Environmental Influences on Conduct Disorder, Attention Deficit Hyperactivity Disorder, and Oppositional Defiant Disorder Symptoms.

Science.gov (United States)

Dick, Danielle M.; Viken, Richard J.; Kaprio, Jaakko; Pulkkinen, Lea; Rose, Richard J.

2005-01-01

Conduct disorder (CD), attention deficit hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD) are common childhood externalizing disorders that frequently co-occur. However, the causes of their comorbidity are not well understood. To address that question, we analyzed data from >600 Finnish twin pairs, who completed standardized…

Quality of higher education: organisational or educational?

DEFF Research Database (Denmark)

Zou, Yihuan; Du, Xiangyun; Rasmussen, Palle

2012-01-01

Based on a study of Chinese university self-evaluation reports, this paper argues that higher education institutions are trying to manage the tensions between educational and organisational quality and the increasing and worldwide concerns about quality assurance. After 30 years of dramatic...... remain an important basis for external review. In an attempt to examine the institutional understanding of quality in higher education, the authors conducted a content analysis study of 53 self-evaluation reports written by a wide range of higher education institutions in China. This study concludes...... educational reform, China has established a nationwide evaluation system for assessing its higher education institutions. This comprehensive system includes a series of procedures for both internal self-evaluation and external peer reviewing, among which self-evaluation reports prepared by each institution...

Emotion work within eldercare and depressive symptoms

DEFF Research Database (Denmark)

Jakobsen, Louise M.; Jorgensen, Anette F. B.; Thomsen, Birthe L.

2016-01-01

Background: Danish professional caregivers have high rates of depressive symptoms. One proposed cause is exposure to emotion work. However, emotion work is usually measured by self-report which may bias results. Objectives: The objective of this study was to examine the association of emotion work......, externally observed at the workplace, with self-reported depressive symptoms of professional caregivers. Design and data sources: The study was a cross-sectional observational study. Data was collected by 9 observers who assessed emotion work stressors and emotion work resources in 124 individual...... professional caregivers working in 56 work units across 10 eldercare homes. Emotion work stressors were defined as i) barriers for empathetic care, ii) taxing aggressive events, and iii) taxing non-aggressive events. Emotion work resources were defined as i) meaningful events, and ii) social interactions...

Quantized fields in external field. Pt. 2

International Nuclear Information System (INIS)

Bellissard, J.

1976-01-01

The case of a charged scalar field is considered first. The existence of the corresponding Green's functions is proved. For weak fields, as well as pure electric or scalar external fields, the Bogoliubov S-operator is shown to be unitary, covariant, causal up-to-a-phase. These results are generalised to a class of higher spin quantized fields, 'nicely' coupled to external fields, which includes the Dirac theory, and in the case of minimal and magnetic dipole coupling, the spin one Petiau-Duffin-Kemmer theory. (orig.) [de

Victims of Rape: Repeated Assessment of Depressive Symptoms.

Science.gov (United States)

Atkeson, Beverly M.; And Others

1982-01-01

Investigated depressive symptoms in rape victims (N=115) for one year following their assaults. Depressive symptoms were higher in victims than in controls. By four months postrape, depressive symptoms in the victim group had diminished, and the victims were no longer significantly different from the nonvictim control group. (Author)

Foster care, externalizing disorders, and antipsychotic use among Medicaid-enrolled youths.

Science.gov (United States)

Vanderwerker, Lauren; Akincigil, Ayse; Olfson, Mark; Gerhard, Tobias; Neese-Todd, Sheree; Crystal, Stephen

2014-10-01

The authors investigated the extent to which clinical diagnoses of externalizing disorders explain higher rates of antipsychotic use by foster care youths. Medicaid claims data from 44 states for 2009 for youths in foster care (N=301,894) and those not in foster care (N=5,092,574) were analyzed, excluding those with schizophrenia, bipolar disorder, autism, and major depressive disorder. Logistic regressions assessed the relationship between foster care, externalizing disorders, and antipsychotic use. Foster care youths had higher rates of externalizing disorders than the comparison group (attention-deficit hyperactivity disorder, 17.3% versus 6.5%; disruptive behavior disorder, 7.2% versus 2.5%; conduct disorder, 2.3% versus .5%) and greater antipsychotic use (7.4% versus 1.4%). Foster care remained a significant predictor of antipsychotic use after control for demographic and diagnostic covariates, including externalizing disorders (adjusted odds ratio=2.59, 95% confidence interval=2.54-2.63). High rates of externalizing disorder diagnoses only partially explained elevated levels of antipsychotic use in this vulnerable population.

Relations of Parenting to Adolescent Externalizing and Internalizing Distress Moderated by Perception of Neighborhood Danger.

Science.gov (United States)

Goldner, Jonathan S; Quimby, Dakari; Richards, Maryse H; Zakaryan, Arie; Miller, Steve; Dickson, Daniel; Chilson, Jessica

2016-01-01

Parental monitoring and warmth have traditionally been studied in the context of White, middle-class families. This article explores optimal levels of these parenting behaviors in preventing adolescent psychopathology in impoverished, urban high-crime areas while accounting for child perceptions of neighborhood danger. In this study, data were collected longitudinally at 2 time points 1 year apart from a sample of 254 African American young adolescents (T1: M age = 12.6 years, 41% male) and their parents. Parental monitoring and warmth, child perception of neighborhood danger, and child internalizing and externalizing behaviors were measured using questionnaires. Child internalizing behaviors were also measured using a time sampling technique capturing in vivo accounts of daily distress. Findings indicated associations between parental monitoring and children's externalizing behaviors along with linear and quadratic associations between parental monitoring and internalizing behaviors. Monitoring and warmth were differentially related to symptoms depending on neighborhood danger level. When children perceived less danger, more monitoring related to less externalizing. When children perceived more danger, more warmth related to less internalizing. In addition, adolescents' perceptions of neighborhood danger emerged as equally strong as monitoring and warmth in predicting symptoms. This study underscores the influence of carefully considering parenting approaches and which techniques optimally prevent adolescents' externalizing, as well as prevent internalizing difficulties. It also highlights how context affects mental health, specifically how perceptions of danger negatively influence adolescents' psychopathology, emphasizing the importance of initiatives to reduce violence in communities.

Can Dual Task Walking Improve in Parkinson's Disease After External Focus of Attention Exercise? A Single Blind Randomized Controlled Trial.

Science.gov (United States)

Beck, Eric N; Intzandt, Brittany N; Almeida, Quincy J

2018-01-01

It may be possible to use attention-based exercise to decrease demands associated with walking in Parkinson's disease (PD), and thus improve dual task walking ability. For example, an external focus of attention (focusing on the effect of an action on the environment) may recruit automatic control processes degenerated in PD, whereas an internal focus (limb movement) may recruit conscious (nonautomatic) control processes. Thus, we aimed to investigate how externally and internally focused exercise influences dual task walking and symptom severity in PD. Forty-seven participants with PD were randomized to either an Externally (n = 24) or Internally (n = 23) focused group and completed 33 one-hour attention-based exercise sessions over 11 weeks. In addition, 16 participants were part of a control group. Before, after, and 8 weeks following the program (pre/post/washout), gait patterns were measured during single and dual task walking (digit-monitoring task, ie, walking while counting numbers announced by an audio-track), and symptom severity (UPDRS-III) was assessed ON and OFF dopamine replacement. Pairwise comparisons (95% confidence intervals [CIs]) and repeated-measures analyses of variance were conducted. Pre to post: Dual task step time decreased in the external group (Δ = 0.02 seconds, CI 0.01-0.04). Dual task step length (Δ = 2.3 cm, CI 0.86-3.75) and velocity (Δ = 4.5 cm/s, CI 0.59-8.48) decreased (became worse) in the internal group. UPDRS-III scores (ON and OFF) decreased (improved) in only the External group. Pre to washout: Dual task step time ( P = .005) and percentage in double support ( P = .014) significantly decreased (improved) in both exercise groups, although only the internal group increased error on the secondary counting task (ie, more errors monitoring numbers). UPDRS-III scores in both exercise groups significantly decreased ( P = .001). Since dual task walking improvements were found immediately, and 8 weeks after the cessation of an

Contextual factors associated with treatment-seeking and higher-risk sexual behaviour in Botswana among men with symptoms of sexually transmitted infections.

Science.gov (United States)

Langeni, Tabitha

2007-11-01

This study investigates contextual factors associated with treatment-seeking behaviour and higher-risk sexual conduct of men symptomatic of sexually transmitted infections (STIs) in Botswana. Data were drawn from a randomly selected, nationally representative sample of 8 222 men, aged 15-64 years, who had reported having symptoms suggestive of an STI during the previous twelve months. Higher-risk behaviour continues to sustain the HIV epidemic in Botswana. At the heart of Botswana's epidemic lies men's reluctance to seek medical treatment, engaging in unprotected sex, and having sex with multiple partners while symptomatic of an STI. The odds of engaging in unprotected sex while symptomatic of an STI were significantly higher among teenage males and males in urban households. For every year's increase in the age difference between partners there was a 28% increase in the odds of the male having had unprotected sex. Being married and having had more than one sexual partner in the last year multiplied the odds of having unprotected sex while symptomatic of an STI by three times. The longer an infected man remained with symptoms before seeking help, the more likely it was to have unprotected sex while infected and the more likely to seek treatment from a traditional healer. Notably, having sought medical treatment from hospitals, clinics and health workers, as opposed to consulting traditional healers, significantly reduced the odds of having had unprotected sex while infected with an STI by 48%. The results indicate the need to encourage men to utilise public healthcare services. The public health sector in Botswana needs to provide healthcare services that are user-friendly for men. Increasing the number of treatment sites may also contribute to preventing onward transmission of STIs. Special attention needs to be paid to boys' socialisation towards gender norms, and men are to be encouraged to play a responsible role in HIV prevention.

Parents' Reports of Children's Internalizing Symptoms: Associations with Parents' Mental Health Symptoms and Substance Use Disorder.

Science.gov (United States)

Kelley, Michelle L; Bravo, Adrian J; Hamrick, Hannah C; Braitman, Abby L; White, Tyler D; Jenkins, Jennika

2017-06-01

This brief report examined the unique associations between parents' ratings of child internalizing symptoms and their own depression and anxiety in families with parental substance use disorder (SUD). Further, we examined whether parental SUD (father only, mother only, both parents) was related to discrepancy in mothers' and fathers' reports of children's internalizing symptoms. Participants were 97 triads (fathers, mothers) in which one or both parents met criteria for SUD. Polynomial regression analyses were conducted to examine whether father-mother reports of child internalizing symptoms had unique associations with parents' own symptoms of depression and anxiety while controlling for child gender, child age, and SUD diagnoses. Controlling for fathers' symptoms and other covariates, mothers experiencing more depression and anxiety symptoms reported more symptoms of child internalizing symptoms than did fathers. Mothers' and fathers' SUD was associated with higher anxiety symptoms among mothers after controlling for other variables. A second set of polynomial regressions examined whether father-mother reports of child internalizing symptoms had unique associations with parents' SUD diagnoses while controlling for child gender and child age. After controlling for mothers' symptoms and other covariates, parents' reports of children's internalizing symptoms were not significantly associated with either parent's SUD or parental SUD interactions (i.e., both parents have SUD diagnoses). Taken together, mothers' ratings of children's internalizing symptoms may be accounted for, in part, by her reports of depression and anxiety symptoms.

Pubertal Timing and Mexican-Origin Girls' Internalizing and Externalizing Symptoms: The Influence of Harsh Parenting

Science.gov (United States)

Deardorff, Julianna; Cham, Heining; Gonzales, Nancy A.; White, Rebecca M. B.; Tein, Jenn-Yun; Wong, Jessie J.; Roosa, Mark W.

2013-01-01

Early-maturing girls are at risk for internalizing and externalizing problems. Research concerning pubertal timing and mental health among Mexican Americans or the influence of parenting behaviors on these relations has been scarce. This study addressed these gaps. This was a prospective examination of 362 Mexican-origin girls and their mothers in…

Patient-reported lower urinary tract symptoms, urinary incontinence, and quality of life after external beam radiotherapy for localized prostate cancer - 15 years' follow-up. A comparison with age-matched controls

International Nuclear Information System (INIS)

Fransson, Per

2008-01-01

Background. To prospectively examine the urinary toxicity and quality of life (QOL) in patients 15 years after external beam radiotherapy (EBRT) for localized prostate cancer (LPC) and compare the outcomes with results for age-matched controls. Material and methods. Urinary symptoms were assessed using the symptom-specific Prostate Cancer Symptom Scale (PCSS) questionnaire, and QOL was assessed with the European Organization for Research and Treatment of Cancer (EORTC)'s Quality of Life Questionnaire (QLQ-C30). Both questionnaires were sent to the surviving 41 patients (25%) and the PCSS questionnaire was sent to 69 age-matched controls for comparison. Results. The response rate was 71% in the patient group and 59% in the control group. Two patients and four controls were excluded due to other cancer diagnoses, resulting in a total of 27 patients and 37 controls for inclusion in the analyses. The mean age in both groups was 78 years. In the patient group, incontinence had increased between the 8-year (mean=0.6) and the 15-year follow-up (mean=2.1; p=0.038). No other differences in urinary problems were seen between these two follow-ups. Increased incontinence, stress incontinence, and pain while urinating were reported by the patients in comparison with the controls at 15 years. Role function was worse in the patient group (mean=67.3) compared with the controls (mean=82.4; p=0.046). The patients also reported more appetite loss, diarrhea, nausea/vomiting, and pain than the controls. Conclusion. EBRT for LPC has divergent effects on urinary symptoms and QOL in comparison with age-matched controls. In our patient population, urinary incontinence increased between 8 and 15 years of follow-up. Otherwise, no differences in urinary symptoms were seen between 4 and 15 years. Incontinence, stress incontinence, and pain while urinating were increased after EBRT in comparison with the controls. Conventional EBRT did not result in a major deterioration in QOL 15 years after

Links between Maternal and Child Psychopathology Symptoms: Mediation through Child Emotion Regulation and Moderation through Maternal Behavior

Science.gov (United States)

Suveg, Cynthia; Shaffer, Anne; Morelen, Diana; Thomassin, Kristel

2011-01-01

This study examined the intergenerational transmission of psychopathology symptoms with 7-12 year-old children (N = 97; 44 boys, 53 girls, M age = 9.14, SD = 1.38) and their mothers (M age = 38.46, SD = 6.86). Child emotion regulation mediated the links between maternal psychopathology and child internalizing and externalizing symptoms. In turn,…

Decreased physical activity attributable to higher body mass index influences fibromyalgia symptoms.

Science.gov (United States)

Vincent, Ann; Clauw, Daniel; Oh, Terry H; Whipple, Mary O; Toussaint, Loren L

2014-09-01

Although previous studies report associations between increased body mass index (BMI) and fibromyalgia symptoms, there is uncertainty as to whether this relationship is driven by physical factors, psychological factors, or both. To assess these relationships in a clinical sample of patients with fibromyalgia. Cross-sectional study. Tertiary care facility. A total of 686 patients from an existing national fibromyalgia registry. Patients completed a demographic form and self-report questionnaires including the Fibromyalgia Impact Questionnaire-Revised (FIQ-R), the Medical Outcomes Study Short Form-36 (SF-36), the Brief Pain Inventory (BPI), and the 30-item Profile of Mood States (30-item POMS). FIQ-R overall impact subscale. BMI was significantly correlated with fibromyalgia impact (P BMI and fibromyalgia impact was almost fully accounted for by physical factors and not by psychological factors. Despite patient report that pain hinders physical activity, clinicians who encounter patients with fibromyalgia, particularly patients with increased BMI, should be cognizant of the need to invest time and resources to counsel patients on physical factors (ie, physical activity) that could improve the patients' symptom experience. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Firm Search for External Knowledge

DEFF Research Database (Denmark)

Sofka, Wolfgang; Grimpe, Christoph

2012-01-01

ignored the institutional context that provides or denies access to external knowledge at the country level. Combining institutional and knowledge search theory, we suggest that the market orientation of the institutional environment and the magnitude of institutional change influence when firms begin......The innovation performance of modern firms is increasingly determined by their ability to search and absorb external knowledge. However, after a certain threshold firms "oversearch" their environment and innovation performance declines. In this paper, we argue that prior literature has largely...... to experience the negative performance effects of oversearch. Based on a comprehensive sample of almost 8,000 firms from ten European countries, we find that institutions matter considerably for firms' search activity. Higher market orientation of institutions increases the effectiveness of firms' search...

The ExternE project: methodology, objectives and limitations

International Nuclear Information System (INIS)

Rabl, A.; Spadaro, J.V.

2002-01-01

This paper presents a summary of recent studies on external costs of energy systems, in particular the ExternE (External Costs of Energy) Project of the European Commission. To evaluate the impact and damage cost of a pollutant, one needs to carry out an impact pathway analysis; this involves the calculation of increased pollutant concentrations in all affected regions due to an incremental emission (e.g. μg/m 3 of particles, using models of atmospheric dispersion and chemistry), followed by the calculation of physical impacts (e.g. number of cases of asthma due to these particles, using a dose-response function). The entire so-called fuel chain (or fuel cycle) is evaluated and compared on the basis of delivered end use energy. Even though the uncertainties are large, the results provide substantial evidence that the classical air pollutants (particles, NO x and SO x ) from the combustion of fossil fuels impose a heavy toll, in addition to the cost of global warming. The external costs are especially large for coal; even for 'good current technology' they may be comparable to the price of electricity. For natural gas the external costs are about a third to a half of coal. The external costs of nuclear are small compared to the price of electricity (at most a few %), and so are the external costs of most renewable energy systems. (authors)

[Parenting practices and internalizing and externalizing problems in Spanish adolescents].

Science.gov (United States)

García Linares, Ma Cruz; Cerezo Rusillo, Ma Teresa; de la Torre Cruz, Manuel Jesús; de la Villa Carpio Fernández, Ma; Casanova Arias, Pedro Félix

2011-11-01

The goal of this study was to analyze the relationship between parenting practices and internalizing and externalizing problems presented by a group of adolescents according to their gender. Four hundred and sixty-nine secondary school students (aged between 12 and 18) participated in this study. The adolescents presented differences in perception of the educational practices of both parents as a function of their gender. Negative parenting practices were positively related to adolescents' internalizing and externalizing problems, whereas positive practices were negatively related to externalizing problems. Moreover, differences between boys and girls were found in predictor variables of problems, and the predictive power of the variables was higher for externalizing problems.

In-Session Caregiver Behavior Predicts Symptom Change in Youth Receiving Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

Science.gov (United States)

Yasinski, Carly; Hayes, Adele; Ready, C. Beth; Cummings, Jorden A.; Berman, Ilana S.; McCauley, Thomas; Webb, Charles; Deblinger, Esther

2016-01-01

Objective Involving caregivers in trauma-focused treatments for youth has been shown to result in better outcomes, but it is not clear which in-session caregiver behaviors enhance or inhibit this effect. The current study examined the associations between caregiver behaviors during Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and youth cognitive processes and symptoms. Method Participants were a racially diverse sample of Medicaid-eligible youth (ages 7–17) and their non-offending caregivers (N= 71 pairs) who received TF-CBT through an effectiveness study in a community setting. Caregiver and youth processes were coded from audio-recorded sessions, and outcomes were measured using the Child Behavior Checklist (CBCL) and UCLA PTSD Reaction Index for DSM-IV (UPID) at 3, 6, 9, and 12 months post-intake. Results Piecewise linear growth curve modeling revealed that during the trauma narrative phase of TF-CBT, caregivers’ cognitive-emotional processing of their own and their child's trauma-related reactions predicted decreases in youth internalizing and externalizing symptoms over treatment. Caregiver support predicted lower internalizing symptoms over follow-up. In contrast, caregiver avoidance and blame of the child predicted worsening of youth internalizing and externalizing symptoms over follow-up. Caregiver avoidance early in treatment also predicted worsening of externalizing symptoms over follow-up. During the narrative phase, caregiver blame and avoidance were correlated with more child overgeneralization of trauma beliefs, and blame was also associated with less child accommodation of balanced beliefs. Conclusions The association between in-session caregiver behaviors and youth symptomatology during and after TF-CBT highlights the importance of assessing and targeting these behaviors to improve clinical outcomes. PMID:27618641

Clinical characteristics of keratosis obturans and external auditory canal cholesteatoma.

Science.gov (United States)

Park, So Young; Jung, Young Hoon; Oh, Jeong-Hoon

2015-02-01

Keratosis obturans (KO) and external auditory canal cholesteatoma (EACC) have been considered separate entities. While the disorders are distinct, they share many overlapping characteristics, making a correct diagnosis difficult. In the present study, we compared their clinical characteristics and radiological features to clarify the diagnostic criteria. Retrospective case series. Academic medical center. The clinical data of 23 cases of EACC and KO were retrospectively reviewed. The following clinical characteristics were compared between the 2 groups: sex, age, onset of symptoms, follow-up period, audiometric results, and imaging findings on temporal bone computed tomography including bilaterality, location, and the presence of extension to adjacent tissue. The mean age of the EACC group was significantly older than that of the KO group. All of the cases of EACC occurred unilaterally, and bilateral occurrences of KO were observed in 4 of 9 cases. All of the lesions in the KO group were circumferential, and no lesion in the EACC group invaded the superior canal wall. No significant differences in symptoms, such as acute otalgia, otorrhea, and hearing loss, were noted between the 2 groups. The incidence of conductive hearing impairment more than 10 dB was higher in the KO group than in the EACC group. Thus, KO and EACC are 2 distinct disease entities that share common features in clinical characteristics except for predominant age and bilaterality. Conservative treatment with meticulous cleaning of the lesion was successful in most cases with a long-term follow-up. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

[A prospective cohort study on the relationship between maternal prenatal depressive symptoms and children's behavioral problems at 2 years old].

Science.gov (United States)

Li, F; Tian, Y P; Liu, X M; Xia, R L; Jin, L M; Sun, X W; Song, X X; Yuan, W; Liang, H

2018-04-10

Objective: To explore the associations between maternal and prenatal depressive symptoms and children's behavioral problems at 2 years old. Methods: In the present study, a total of 491 mother-child pairs were selected from the Shanghai-Minhang Birth Cohort Study (S-MBCS) which was conducted in Maternal and Child Health Hospital of Minhang District in Shanghai between April and December, 2012. Data from the Center for Epidemiologic Studies on Depression was gathered to assess the maternal depressive symptoms in the second and third trimester of pregnancy, as well as at 6 months and 12 months postpartum. Neurodevelopment at 2 years was assessed, using the Child Behavior Checklist. We used generalized linear models with a log-link function and a Binomial distribution to estimate the risk ratios ( RR s) and 95% CI s, on children's behavioral problems at 2 years of age. Sensitivity analyses were performed among participants without postpartum depressive symptoms. Results: After adjustment on factors as maternal age, gestation week, average monthly income per person, parental education and children's gender etc ., maternal depression in second trimester of pregnancy was found associated with higher risk of both developing emotional ( RR =2.61, 95% CI : 1.36-4.99) and internalizing problems ( RR =1.94, 95% CI : 1.22-3.08). However, maternal depression in third trimester was found to be associated with higher risks of developing emotional ( RR =6.46, 95% CI : 3.09-13.53), withdrawn ( RR =2.42, 95% CI : 1.16-5.02), aggressive ( RR =2.93, 95% CI : 1.45-5.94), internalizing ( RR =1.79, 95% CI : 1.01-3.16) or externalizing problems ( RR =2.56, 95% CI :1.49-4.42). In sensitivity analysis, antenatal maternal depression was found positively associated with children's emotional, internalizing and externalizing problems and the differences all statistically significant. Conclusions: Maternal depression during pregnancy might increase the risks of children's behavioral problems. In

Older age, higher perceived disability and depressive symptoms predict the amount and severity of work-related difficulties in persons with multiple sclerosis.

Science.gov (United States)

Raggi, Alberto; Giovannetti, Ambra Mara; Schiavolin, Silvia; Brambilla, Laura; Brenna, Greta; Confalonieri, Paolo Agostino; Cortese, Francesca; Frangiamore, Rita; Leonardi, Matilde; Mantegazza, Renato Emilio; Moscatelli, Marco; Ponzio, Michela; Torri Clerici, Valentina; Zaratin, Paola; De Torres, Laura

2018-04-16

This cross-sectional study aims to identify the predictors of work-related difficulties in a sample of employed persons with multiple sclerosis as addressed with the Multiple Sclerosis Questionnaire for Job Difficulties. Hierarchical linear regression analysis was conducted to identify predictors of work difficulties: predictors included demographic variables (age, formal education), disease duration and severity, perceived disability and psychological variables (cognitive dysfunction, depression and anxiety). The targets were the questionnaire's overall score and its six subscales. A total of 177 participants (108 females, aged 21-63) were recruited. Age, perceived disability and depression were direct and significant predictors of the questionnaire total score, and the final model explained 43.7% of its variation. The models built on the questionnaire's subscales show that perceived disability and depression were direct and significant predictors of most of its subscales. Our results show that, among patients with multiple sclerosis, those who were older, with higher perceived disability and higher depression symptoms have more and more severe work-related difficulties. The Multiple Sclerosis Questionnaire for Job Difficulties can be fruitfully exploited to plan tailored actions to limit the likelihood of near-future job loss in persons of working age with multiple sclerosis. Implications for rehabilitation Difficulties with work are common among people with multiple sclerosis and are usually addressed in terms of unemployment or job loss. The Multiple Sclerosis Questionnaire for Job Difficulties is a disease-specific questionnaire developed to address the amount and severity of work-related difficulties. We found that work-related difficulties were associated to older age, higher perceived disability and depressive symptoms. Mental health issues and perceived disability should be consistently included in future research targeting work-related difficulties.

Recruitment in an indicated prevention program for externalizing behavior - parental participation decisions

Directory of Open Access Journals (Sweden)

Beckers Gabriele

2010-05-01

Full Text Available Abstract Background Parents are the ones who decide whether or not to participate in parent focused prevention trials. Their decisions may be affected by internal factors (e.g., personality, attitudes, sociodemographic characteristics or external barriers. Some of these barriers are study-related and others are intervention-related. Internal as well as external barriers are especially important at the screening stage, which aims to identify children and families at risk and for whom the indicated prevention programs are designed. Few studies have reported their screening procedure in detail or analyzed differences between participants and dropouts or predictors of dropout. Rates of participation in prevention programs are also of interest and are an important contributor to the efficacy of a prevention procedure. Methods In this study, we analyzed the process of parent recruitment within an efficacy study of the indicated Prevention Program for Externalizing Problem behavior (PEP. We determined the retention rate at each step of the study, and examined differences between participants and dropouts/decliners. Predictors of dropout at each step were identified using logistic regression. Results Retention rates at the different steps during the course of the trial from screening to participation in the training ranged from 63.8% (pre-test to 81.1% (participation in more than 50% of the training sessions. Parents who dropped out of the study were characterized by having a child with lower symptom intensity by parent rating but higher ratings by teachers in most cases. Low socioeconomic status and related variables were also identified as predictors of dropout in the screening (first step and for training intensity (last step. Conclusions Special attention should be paid to families at increased risk for non-participation when implementing the prevention program in routine care settings. Trial Registration ISRCTN12686222

Posttraumatic stress disorder symptoms in youth with vs without chronic pain.

Science.gov (United States)

Noel, Melanie; Wilson, Anna C; Holley, Amy Lewandowski; Durkin, Lindsay; Patton, Michaela; Palermo, Tonya M

2016-10-01

Chronic pain and posttraumatic stress disorder (PTSD) symptoms have been found to co-occur in adults; however, research has not examined this co-occurrence in adolescence, when pediatric chronic pain often first emerges. The aims of this study were to compare the frequency and intensity of PTSD symptoms and stressful life events in cohorts of youth with (n = 95) and without (n = 100) chronic pain and their parents and to determine the association between PTSD symptoms, health-related quality of life, and pain symptoms within the chronic pain sample. All participants completed questionnaire measures through an online survey. Findings revealed that youth with chronic pain and their parents had significantly higher levels of PTSD symptoms as compared with pain-free peers. More youth with chronic pain (32%) and their parents (20%) reported clinically significant elevations in PTSD symptoms than youth without chronic pain (8%) and their parents (1%). Youth with chronic pain also reported a greater number of stressful life events than those without chronic pain, and this was associated with higher PTSD symptoms. Among the chronic pain cohort, higher levels of PTSD symptoms were predictive of worse health-related quality of life and were associated with higher pain intensity, unpleasantness, and interference. Results suggest that elevated PTSD symptoms are common and linked to reduced functioning among youth with chronic pain. Future research is needed to examine PTSD at the diagnostic level and the underlying mechanisms that may explain why this co-occurrence exists.

External costs related to power production technologies. ExternE national implementation for Denmark

International Nuclear Information System (INIS)

Schleisner, L.; Sieverts Nielsen, P.

1997-12-01

The objective of the ExternE National Implementation project has been to establish a comprehensive and comparable set of data on externalities of power generation for all EU member states and Norway. The tasks include the application of the ExternE methodology to the most important fuel cycles for each country as well as to update the already existing results; to aggregate these site- and technology-specific results to more general figures. The current report covers the results of the national implementation for Denmark. Three different fuel cycles have been chosen as case studies. These are fuel cycles for an offshore wind farm and a wind farm on land, a decentralised CHP plant based on natural gas and a decentralised CHP plant based on biogas. The report covers all the details of the application of the methodology to these fuel cycles aggregation to a national level. (au) EU-JOULE 3. 59 tabs., 25 ills., 61 refs

External costs related to power production technologies. ExternE national implementation for Denmark

Energy Technology Data Exchange (ETDEWEB)

Schleisner, L; Sieverts Nielsen, P

1997-12-01

The objective of the ExternE National Implementation project has been to establish a comprehensive and comparable set of data on externalities of power generation for all EU member states and Norway. The tasks include the application of the ExternE methodology to the most important fuel cycles for each country as well as to update the already existing results; to aggregate these site- and technology-specific results to more general figures. The current report covers the results of the national implementation for Denmark. Three different fuel cycles have been chosen as case studies. These are fuel cycles for an offshore wind farm and a wind farm on land, a decentralised CHP plant based on natural gas and a decentralised CHP plant based on biogas. The report covers all the details of the application of the methodology to these fuel cycles aggregation to a national level. (au) EU-JOULE 3. 59 tabs., 25 ills., 61 refs.

Environmental externalities related to power production on biogas and natural gas based on the EU ExternE methodology

DEFF Research Database (Denmark)

Nielsen, Per Sieverts; Ibsen, Liselotte Schleisner

1998-01-01

This paper assesses the environmental impacts and external costs from selected electricity generation systems in Denmark. The assessment is carried out as part of the ExternE National Implementation, which is the second phase of the ExternE project and involves case studies from all Western...... European countries. The project use a “bottom-up” methodology to evaluate the external costs associated with a wide range of different fuel cycles. The project has identified priority impacts, where most are impacts from air emissions. Externalities due to atmospheric emissions are calculated through...

Quantifying the impact of transient joint symptoms, chronic joint symptoms, and arthritis: a population-based approach.

Science.gov (United States)

Busija, Lucy; Buchbinder, Rachelle; Osborne, Richard H

2009-10-15

To estimate the prevalence and co-occurrence of self-reported doctor-diagnosed arthritis, chronic joint symptoms (pain, aching, stiffness, or swelling on most days for a month), and transient joint symptoms (pain, aching, stiffness, or swelling but not on most days for a month), and to compare the sociodemographic characteristics, activity limitations, and health-related quality of life (HRQOL) of people with joint conditions with those who have no self-reported doctor-diagnosed arthritis and no joint symptoms. Data from the 2004 population-based South Australian Health Omnibus Survey (n = 2,840, ages 18-96 years) were used in the study. Activity limitations were assessed using 10 activity limitations questions from the Short Form 36 health survey. HRQOL was assessed using the Assessment of Quality of Life scale. Half of all respondents reported having joint problems, with 26%, 11%, and 13% reporting self-reported doctor-diagnosed arthritis, chronic joint symptoms, and transient joint symptoms, respectively. Chronic joint conditions (self-reported doctor-diagnosed arthritis and chronic joint symptoms) accounted for 74% of all joint problems and were associated with higher odds of activity limitations and poorer HRQOL. The frequency of transient and chronic joint symptoms was highest among middle-aged participants (ages 45-54 years for transient and 45-64 years for chronic joint symptoms) and those who had a body mass index in the obese range. Prevalence of self-reported doctor-diagnosed arthritis increased with age and was higher among women and those who were overweight or obese. This study documented the high prevalence and impact of joint conditions in the community. Chronic joint conditions affect daily life and are substantial barriers for effective public health interventions aimed at reducing obesity and inactivity.

Coexisting anxiety and depressive symptoms in patients with heart failure.

Science.gov (United States)

Dekker, Rebecca L; Lennie, Terry A; Doering, Lynn V; Chung, Misook L; Wu, Jia-Rong; Moser, Debra K

2014-04-01

Among patients with heart failure (HF), anxiety symptoms may co-exist with depressive symptoms. However, the extent of overlap and risk factors for anxiety symptoms have not been thoroughly described. The aim of this study was to describe the coexistence of anxiety and depressive symptoms, and to determine the predictors of anxiety symptoms in patients with HF. The sample consisted of 556 outpatients with HF (34% female, 62±12 years, 54% New York Heart Association (NYHA) class III/IV) enrolled in a multicenter HF quality of life registry. Anxiety symptoms were assessed with the Brief Symptom Inventory-anxiety subscale. Depressive symptoms were measured with the Beck Depression Inventory-II (BDI). We used a cut-point of 0.35 to categorize patients as having anxiety symptoms or no anxiety symptoms. Logistic regression was used to determine whether age, gender, minority status, educational level, functional status, comorbidities, depressive symptoms, and antidepressant use were predictors of anxiety symptoms. One-third of patients had both depressive and anxiety symptoms. There was a dose-response relationship between depressive symptoms and anxiety symptoms; higher levels of depressive symptoms were associated with a higher level of anxiety symptoms. Younger age (odds ratio (OR)= 0.97, p=0.004, 95% confidence interval (CI) 0.95-0.99) and depressive symptoms (OR =1.25, panxiety symptoms. Patients with HF and depressive symptoms are at high risk for experiencing anxiety symptoms. Clinicians should assess these patients for comorbid anxiety symptoms. Research is needed to test interventions for both depressive and anxiety symptoms.

Parenting, identity development, internalizing symptoms, and alcohol use: a cross-sectional study in a group of Italian adolescents

Directory of Open Access Journals (Sweden)

Pellerone M

2016-07-01

Full Text Available Monica Pellerone, Giacomo Tolini, Caterina Polopoli Faculty of Human and Social Sciences, “Kore” University of Enna, Enna, Italy Background: Literature has demonstrated the adaptive function of identity development and parenting toward manifestation of problem behaviors in adolescence. These dimensions act on both internalizing and externalizing symptoms.Methods: The objective is to investigate the relationship between identity status, parenting, and adolescent problems, which may manifest through internalized (phobias, obsessions, depression, eating disorders, entropy and externalized modes (alcohol use and school discomfort. The research involved 198 Italian students (104 males and 94 females in the 4th year (mean =16.94 years, standard deviation =0.35 and 5th year (mean =17.94 years, standard deviation =0.43 of senior secondary schools, who live in Caltanissetta, a town located in Sicily, Italy. The research lasted for 1 school year. The general group consisted of 225 students with a mortality rate of 12%. They completed an anamnestic questionnaire to provide 1 basic information, 2 alcohol consumption attitude in the past 30 days, and 3 their beliefs about alcohol; the “Ego Identity Process Questionnaire” to investigate identity development; the “Parental Bonding Instrument” to measure the perception of parenting during childhood; and the “Constraints of Mind” to value the presence of internalizing symptoms.Results: Data show that identity status influences alcohol consumption. Low-profile identity and excessive maternal control affect the relational dependence and the tendency to perfectionism in adolescents. Among the predictors of alcohol use, there are socioeconomic status, parental control, and the presence of internalizing symptoms.Conclusion: Family is the favored context of learning beliefs, patterns, and values that affect the broader regulatory social environment, and for this reason, it is considered the privileged

'More is less'. The tax effects of ignoring flow externalities

International Nuclear Information System (INIS)

Sandal, Leif K.; Steinshamn, Stein Ivar; Grafton, R. Quentin

2003-01-01

Using a model of non-linear, non-monotone decay of the stock pollutant, and starting from the same initial conditions, the paper shows that an optimal tax that corrects for both stock and flow externalities may result in a lower tax, fewer cumulative emissions (less decay in emissions) and higher output at the steady state than a corrective tax that ignores the flow externality. This 'more is less' result emphasizes that setting a corrective tax that ignores the flow externality, or imposing a corrective tax at too low a level where there exists only a stock externality, may affect both transitory and steady-state output, tax payments and cumulative emissions. The result has important policy implications for decision makers setting optimal corrective taxes and targeted emission limits whenever stock externalities exist

Effects of Parental Depressive Symptoms on Child Adjustment Moderated by Hypothalamic Pituitary Adrenal Activity: Within- and between-Family Risk

Science.gov (United States)

Laurent, Heidemarie K.; Leve, Leslie D.; Neiderhiser, Jenae M.; Natsuaki, Misaki N.; Shaw, Daniel S.; Fisher, Philip A.; Marceau, Kristine; Harold, Gordon T.; Reiss, David

2013-01-01

Child hypothalamic pituitary adrenal (HPA) activity was investigated as a moderator of parental depressive symptom effects on child behavior in an adoption sample ("n" = 210 families). Adoptive parents' depressive symptoms and child internalizing and externalizing were assessed at 18, 27, and 54 months, and child morning and evening HPA…

The heterogeneity of attention-deficit/hyperactivity disorder symptoms and conduct problems: Cognitive inhibition, emotion regulation, emotionality, and disorganized attachment.

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Forslund, Tommie; Brocki, Karin C; Bohlin, Gunilla; Granqvist, Pehr; Eninger, Lilianne

2016-09-01

This study examined the contributions of several important domains of functioning to attention-deficit/hyperactivity disorder (ADHD) symptoms and conduct problems. Specifically, we investigated whether cognitive inhibition, emotion regulation, emotionality, and disorganized attachment made independent and specific contributions to these externalizing behaviour problems from a multiple pathways perspective. The study included laboratory measures of cognitive inhibition and disorganized attachment in 184 typically developing children (M age = 6 years, 10 months, SD = 1.7). Parental ratings provided measures of emotion regulation, emotionality, and externalizing behaviour problems. Results revealed that cognitive inhibition, regulation of positive emotion, and positive emotionality were independently and specifically related to ADHD symptoms. Disorganized attachment and negative emotionality formed independent and specific relations to conduct problems. Our findings support the multiple pathways perspective on ADHD, with poor regulation of positive emotion and high positive emotionality making distinct contributions to ADHD symptoms. More specifically, our results support the proposal of a temperamentally based pathway to ADHD symptoms. The findings also indicate that disorganized attachment and negative emotionality constitute pathways specific to conduct problems rather than to ADHD symptoms. © 2016 The British Psychological Society.

Depressive symptoms and bias in perceived social competence among young adults.

Science.gov (United States)

Whitton, Sarah W; Larson, Justine J; Hauser, Stuart T

2008-07-01

We examined associations between depressive symptoms and young adults' self-perceptions of social competence to explore whether higher symptoms are associated with self-evaluations that are more accurate (i.e., depressive realism), negatively biased (i.e., cognitive distortion), or less accurate (i.e., self-verification perspective). In 133 young adults, depressive symptoms and discrepancies between self- and peer ratings of social competence were assessed. Results demonstrated a linear relationship between depressive symptoms and self-peer discrepancies, such that higher symptoms were associated with underestimation of the self and low symptom levels were linked with overestimation of the self relative to peer evaluations. These findings suggest negative bias in dysphorics' self-perceptions, supporting cognitive distortion models, as well as positive bias in self-perceptions of those with low depressive symptoms. Copyright 2008 Wiley Periodicals, Inc.

Patient-reported lower urinary tract symptoms, urinary incontinence, and quality of life after external beam radiotherapy for localized prostate cancer - 15 years' follow-up. A comparison with age-matched controls

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Fransson, Per (Dept. of Radiation Sciences, Oncology, Umeaa Univ., Umeaa (Sweden))

2008-06-15

Background. To prospectively examine the urinary toxicity and quality of life (QOL) in patients 15 years after external beam radiotherapy (EBRT) for localized prostate cancer (LPC) and compare the outcomes with results for age-matched controls. Material and methods. Urinary symptoms were assessed using the symptom-specific Prostate Cancer Symptom Scale (PCSS) questionnaire, and QOL was assessed with the European Organization for Research and Treatment of Cancer (EORTC)'s Quality of Life Questionnaire (QLQ-C30). Both questionnaires were sent to the surviving 41 patients (25%) and the PCSS questionnaire was sent to 69 age-matched controls for comparison. Results. The response rate was 71% in the patient group and 59% in the control group. Two patients and four controls were excluded due to other cancer diagnoses, resulting in a total of 27 patients and 37 controls for inclusion in the analyses. The mean age in both groups was 78 years. In the patient group, incontinence had increased between the 8-year (mean=0.6) and the 15-year follow-up (mean=2.1; p=0.038). No other differences in urinary problems were seen between these two follow-ups. Increased incontinence, stress incontinence, and pain while urinating were reported by the patients in comparison with the controls at 15 years. Role function was worse in the patient group (mean=67.3) compared with the controls (mean=82.4; p=0.046). The patients also reported more appetite loss, diarrhea, nausea/vomiting, and pain than the controls. Conclusion. EBRT for LPC has divergent effects on urinary symptoms and QOL in comparison with age-matched controls. In our patient population, urinary incontinence increased between 8 and 15 years of follow-up. Otherwise, no differences in urinary symptoms were seen between 4 and 15 years. Incontinence, stress incontinence, and pain while urinating were increased after EBRT in comparison with the controls. Conventional EBRT did not result in a major deterioration in QOL 15 years

Attribution style as a factor in psychosis and symptom resolution.

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Mizrahi, Romina; Addington, Jean; Remington, Gary; Kapur, Shitij

2008-09-01

Attribution (AT) style theory provides a framework for understanding the causal explanations that individuals give for their own behaviour and the behaviour of others. It has been suggested that patients with persecutory delusions excessively attribute hypothetical positive events to internal causes (self) and hypothetical negative events to external personal causes. Despite this, how AT associates with psychotic symptoms (not only persecutory delusions) and how it changes with the resolution of psychosis has never been investigated. We conducted a cross-sectional study to investigate how AT is associated with psychopathology and a longitudinal study to examine the change of AT during the first 6 weeks of antipsychotic treatment and the relationship with psychopathology improvement. 86 patients meeting DSM-IV criteria for schizophrenia and related psychotic disorders were included in the cross-sectional study, and 17 patients in the longitudinal study. The longitudinal group were free of antipsychotic drugs at baseline and followed for 6 weeks after being started on antipsychotic medication by their psychiatrist. We used the Internal, Personal and Situational Attributions Questionnaire (IPSAQ) as a measure of AT. Patients that tend to internalize (i.e. less self-serving bias), showed greater overall psychopathology, as measured by PANSS-Total (F(2,83)=6.59, p=0.002), with a trend toward significance for PANSS-Positive (F(2,83)=2.62 p=0.07). Longitudinally, having a low self-serving bias was associated with poorer response to antipsychotic treatment. Further, externalizing bias seems to change early on in treatment (F=9.65 df=1,15 p=0.007) and reach ceiling effects thereafter. AT is related to overall symptom severity, with internalizing style linked to higher global psychopathology. Antipsychotic treatment has little effect on AT, at least within 6 weeks of antipsychotic exposure, and only a modest effect is on EB which plateaus within 2 weeks. Finally

Family income, parental education and internalizing and externalizing psychopathology among 2-3-year-old Chinese children: the mediator effect of parent-child conflict.

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Zhang, Xiao

2014-02-01

Using a sample of 156 Chinese children aged 2-3 years and their parents, this study examined the effects of socio-economic status, specifically family income and parental education, on the children's internalizing and externalizing psychopathology and whether these effects were mediated by mother-child and father-child conflict. Results indicated that family income, maternal education and paternal education all negatively predicted externalizing symptoms. Income also negatively predicted internalizing symptoms among boys but not girls. Maternal education negatively predicted internalizing symptoms among girls but not boys. The effects of income on psychopathology were fully mediated by mother-child and father-child conflict. In contrast, the effects of education were not mediated or only partially mediated by conflict. Findings are discussed in the framework of the family stress model. © 2013 International Union of Psychological Science.

External ophthalmomyiasis presenting to an emergency department: corneal findings as a sign of Oestrus ovis.

Science.gov (United States)

Gholamhossein, Yaghoubi; Behrouz, Heydari

2013-10-01

This study aims to determine the frequency of opthalmyomyiasis externa and the ocular findings of disease in Southern Khorasan. All patients referred to the emergency department of Valiaser hospital during the year 2011 with external ophthalmomyiasis were enrolled in this study. The diagnosis of external ophthalmomyiasis was made according to clinical findings and the presence of Oestrus ovis larvae. There were 18 cases of external ophthalmomyiasis in the emergency department of Valiaser hospital in 2011. Most cases had the common signs and symptoms of allergic conjunctivitis, except for three males who were referred with respective complaints of red eye, foreign body sensation, and swelling around the eyelids after contact injury the previous day; corneal infiltration was present in three cases. The visual acuity among the three cases that had peripheral corneal involvement was 20 / 30 in both eyes. The bulbar conjunctiva showed chemosis in all cases and a ropy pattern discharge that was clinically compatible with external ophthalmomyiasis. However, in one case, microscopic slit lamp examination did not show Oestrus ovis larvae. The frequency of external ophthalmomyiasis was high in this region. Although external ophthalmomyiasis usually manifests as allergic conjunctivitis, coronary-like corneal infiltration may be considered in the differential diagnosis of external ophthalmomyiasis or toxic insult.

Statistical-learning strategies generate only modestly performing predictive models for urinary symptoms following external beam radiotherapy of the prostate: A comparison of conventional and machine-learning methods

International Nuclear Information System (INIS)

Yahya, Noorazrul; Ebert, Martin A.; Bulsara, Max; House, Michael J.; Kennedy, Angel; Joseph, David J.; Denham, James W.

2016-01-01

Purpose: Given the paucity of available data concerning radiotherapy-induced urinary toxicity, it is important to ensure derivation of the most robust models with superior predictive performance. This work explores multiple statistical-learning strategies for prediction of urinary symptoms following external beam radiotherapy of the prostate. Methods: The performance of logistic regression, elastic-net, support-vector machine, random forest, neural network, and multivariate adaptive regression splines (MARS) to predict urinary symptoms was analyzed using data from 754 participants accrued by TROG03.04-RADAR. Predictive features included dose-surface data, comorbidities, and medication-intake. Four symptoms were analyzed: dysuria, haematuria, incontinence, and frequency, each with three definitions (grade ≥ 1, grade ≥ 2 and longitudinal) with event rate between 2.3% and 76.1%. Repeated cross-validations producing matched models were implemented. A synthetic minority oversampling technique was utilized in endpoints with rare events. Parameter optimization was performed on the training data. Area under the receiver operating characteristic curve (AUROC) was used to compare performance using sample size to detect differences of ≥0.05 at the 95% confidence level. Results: Logistic regression, elastic-net, random forest, MARS, and support-vector machine were the highest-performing statistical-learning strategies in 3, 3, 3, 2, and 1 endpoints, respectively. Logistic regression, MARS, elastic-net, random forest, neural network, and support-vector machine were the best, or were not significantly worse than the best, in 7, 7, 5, 5, 3, and 1 endpoints. The best-performing statistical model was for dysuria grade ≥ 1 with AUROC ± standard deviation of 0.649 ± 0.074 using MARS. For longitudinal frequency and dysuria grade ≥ 1, all strategies produced AUROC>0.6 while all haematuria endpoints and longitudinal incontinence models produced AUROC<0.6. Conclusions

Statistical-learning strategies generate only modestly performing predictive models for urinary symptoms following external beam radiotherapy of the prostate: A comparison of conventional and machine-learning methods

Energy Technology Data Exchange (ETDEWEB)

Yahya, Noorazrul, E-mail: noorazrul.yahya@research.uwa.edu.au [School of Physics, University of Western Australia, Western Australia 6009, Australia and School of Health Sciences, National University of Malaysia, Bangi 43600 (Malaysia); Ebert, Martin A. [School of Physics, University of Western Australia, Western Australia 6009, Australia and Department of Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia 6008 (Australia); Bulsara, Max [Institute for Health Research, University of Notre Dame, Fremantle, Western Australia 6959 (Australia); House, Michael J. [School of Physics, University of Western Australia, Western Australia 6009 (Australia); Kennedy, Angel [Department of Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia 6008 (Australia); Joseph, David J. [Department of Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia 6008, Australia and School of Surgery, University of Western Australia, Western Australia 6009 (Australia); Denham, James W. [School of Medicine and Public Health, University of Newcastle, New South Wales 2308 (Australia)

2016-05-15

Purpose: Given the paucity of available data concerning radiotherapy-induced urinary toxicity, it is important to ensure derivation of the most robust models with superior predictive performance. This work explores multiple statistical-learning strategies for prediction of urinary symptoms following external beam radiotherapy of the prostate. Methods: The performance of logistic regression, elastic-net, support-vector machine, random forest, neural network, and multivariate adaptive regression splines (MARS) to predict urinary symptoms was analyzed using data from 754 participants accrued by TROG03.04-RADAR. Predictive features included dose-surface data, comorbidities, and medication-intake. Four symptoms were analyzed: dysuria, haematuria, incontinence, and frequency, each with three definitions (grade ≥ 1, grade ≥ 2 and longitudinal) with event rate between 2.3% and 76.1%. Repeated cross-validations producing matched models were implemented. A synthetic minority oversampling technique was utilized in endpoints with rare events. Parameter optimization was performed on the training data. Area under the receiver operating characteristic curve (AUROC) was used to compare performance using sample size to detect differences of ≥0.05 at the 95% confidence level. Results: Logistic regression, elastic-net, random forest, MARS, and support-vector machine were the highest-performing statistical-learning strategies in 3, 3, 3, 2, and 1 endpoints, respectively. Logistic regression, MARS, elastic-net, random forest, neural network, and support-vector machine were the best, or were not significantly worse than the best, in 7, 7, 5, 5, 3, and 1 endpoints. The best-performing statistical model was for dysuria grade ≥ 1 with AUROC ± standard deviation of 0.649 ± 0.074 using MARS. For longitudinal frequency and dysuria grade ≥ 1, all strategies produced AUROC>0.6 while all haematuria endpoints and longitudinal incontinence models produced AUROC<0.6. Conclusions

External costs of material recycling strategies for fusion power plants

International Nuclear Information System (INIS)

Hallberg, B.; Aquilonius, K.; Lechon, Y.; Cabal, H.; Saez, R.M.; Schneider, T.; Lepicard, S.; Ward, D.; Hamacher, T.; Korhonen, R.

2003-01-01

This paper is based on studies performed within the framework of the project Socio-Economic Research on Fusion (SERF3). Several fusion power plant designs (SEAFP Models 1-6) were compared focusing on part of the plant's life cycle: environmental impact of recycling the materials. Recycling was considered for materials replaced during normal operation, as well as materials from decommissioning of the plant. Environmental impact was assessed and expressed as external cost normalised with the total electrical energy output during plant operation. The methodology used for this study has been developed by the Commission of the European Union within the frame of the ExternE project. External costs for recycling, normalised with the energy production during plant operation, are very low compared with those for other energy sources. Results indicate that a high degree of recycling is preferable, at least when considering external costs, because external costs of manufacturing of new materials and disposal costs are higher

Family routine moderates the relation between child impulsivity and oppositional defiant disorder symptoms.

Science.gov (United States)

Lanza, H Isabella; Drabick, Deborah A G

2011-01-01

Although child impulsivity is associated with oppositional defiant disorder (ODD) symptoms, few studies have examined whether family processes moderate this association. To address this gap, we tested whether child-reported family routine moderated the relation between child hyperactivity/impulsivity (HI) and ODD symptoms among a sample of low-income, urban, ethnic-minority children (N = 87, 51% male). Child HI and ODD symptoms were assessed using parent and teacher reports. HI also was indexed by a laboratory task. Family routine was assessed using child self-report. Hierarchical regression analyses indicated that family routine moderated child HI. Among children with higher levels of teacher-reported HI symptoms, lower levels of family routine were associated with higher levels of teacher-reported ODD symptoms compared to children with lower levels of teacher-reported HI symptoms. Children who self-reported higher levels of family routine were rated as low on teacher-reported ODD symptoms, regardless of teacher-reported HI levels. Parent report and laboratory measures of child HI did not produce significant interactions. Lower levels of family routine may confer risk for ODD symptoms among low-income, urban, ethnic-minority children experiencing higher levels of HI.

Association between psychiatric symptoms and erectile dysfunction.

Science.gov (United States)

Corona, Giovanni; Ricca, Valdo; Bandini, Elisa; Mannucci, Edoardo; Petrone, Luisa; Fisher, Alessandra D; Lotti, Francesco; Balercia, Giancarlo; Faravelli, Carlo; Forti, Gianni; Maggi, Mario

2008-02-01

Erectile dysfunction (ED) is often associated with a wide array of psychiatric symptoms, although few studies systematically address their specific association with ED determinants. The aim of this study is to explore the relationship between ED (as assessed by SIEDY Structured Interview, a 13-item tool which identifies and quantifies the contribution of organic, relational, and intrapsychic domains of ED) and different psychopathological symptoms (as assessed by the Middlesex Hospital Questionnaire, a self-reported test for the screening of mental disorders in a nonpsychiatric setting). A consecutive series of 1,388 (mean age 51 +/- 13 years) male patients with ED was studied. Several hormonal and biochemical parameters were investigated, along with SIEDY Interview and the Middlesex Hospital Questionnaire. Psychiatric symptoms resulted differentially associated with SIEDY domains. Depressive and phobic-anxiety symptoms were associated with the relational domain, somatization with the organic one, while free-floating anxiety, obsessive-compulsive, and phobic symptoms were significantly related with higher intrapsychic SIEDY scores. In addition, relevant depressive symptomatology was associated with hypogonadism, the presence of low frequency of intercourse, hypoactive sexual desire (HSD), and conflictual relationships within the couple and the family. Patients with high free-floating anxiety symptoms were younger, and complained of an unsatisfactory work and a conflictual relationship within family. Conversely, subjects with higher phobic anxious symptoms displayed a more robust relational functioning. Similar results were observed in subjects with obsessive-compulsive symptoms, who also reported a lower prevalence of HSD. Finally, subjects with somatization symptoms showed the worst erectile function. The main value of this study is that it alters various clinicians' belief that many psychiatric symptoms can be found among ED patients. Systematic testing of

Higher prevalence of depressive symptoms in middle-aged men with low serum cholesterol levels

NARCIS (Netherlands)

P.H.A. Steegmans; A.W. Hoes (Arno); A.A.A. Bak (Annette); E. van der Does (Emiel); D.E. Grobbee (Diederick)

2000-01-01

textabstractOBJECTIVE: Investigators from several studies have reported a positive relationship between low cholesterol levels and death due to violent causes (eg, suicide and accidents), possibly mediated by depressive symptoms, aggression or hostility, or

In-session caregiver behavior predicts symptom change in youth receiving trauma-focused cognitive behavioral therapy (TF-CBT).

Science.gov (United States)

Yasinski, Carly; Hayes, Adele M; Ready, C Beth; Cummings, Jorden A; Berman, Ilana S; McCauley, Thomas; Webb, Charles; Deblinger, Esther

2016-12-01

Involving caregivers in trauma-focused treatments for youth has been shown to result in better outcomes, but it is not clear which in-session caregiver behaviors enhance or inhibit this effect. The current study examined the associations between caregiver behaviors during Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and youth cognitive processes and symptoms. Participants were a racially diverse sample of Medicaid-eligible youth (ages 7-17) and their nonoffending caregivers (N = 71 pairs) who received TF-CBT through an effectiveness study in a community setting. Caregiver and youth processes were coded from audio-recorded sessions, and outcomes were measured using the Child Behavior Checklist (CBCL) and UCLA PTSD Reaction Index for Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV; UPID) at 3, 6, 9, and 12 months postintake. Piecewise linear growth curve modeling revealed that during the trauma narrative phase of TF-CBT, caregivers' cognitive-emotional processing of their own and their child's trauma-related reactions predicted decreases in youth internalizing and externalizing symptoms over treatment. Caregiver support predicted lower internalizing symptoms over follow-up. In contrast, caregiver avoidance and blame of the child predicted worsening of youth internalizing and externalizing symptoms over follow-up. Caregiver avoidance early in treatment also predicted worsening of externalizing symptoms over follow-up. During the narrative phase, caregiver blame and avoidance were correlated with more child overgeneralization of trauma beliefs, and blame was also associated with less child accommodation of balanced beliefs. The association between in-session caregiver behaviors and youth symptomatology during and after TF-CBT highlights the importance of assessing and targeting these behaviors to improve clinical outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Higher body mass index may induce asthma among adolescents with pre-asthmatic symptoms: a prospective cohort study

Directory of Open Access Journals (Sweden)

Myers Leann

2011-07-01

Full Text Available Abstract Background Limited studies have prospectively examined the role of body mass index (BMI as a major risk factor for asthma during adolescence. This study investigates whether BMI is associated with increased risk of developing physician-diagnosed asthma during 12-month follow-up among adolescents with undiagnosed asthma-like symptoms at baseline. Methods A total of 4,052 adolescents with undiagnosed asthma-like symptoms at baseline were re-examined after a 12-month follow-up. Asthma cases were considered confirmed only after diagnosis by a physician based on the New England core and International Study of Asthma and Allergies in Childhood (ISAAC criteria video questionnaires, and accompanying pulmonary function tests. Logistic regression analyses were used to evaluate the relationship of BMI and the risk of acquiring asthma. Results The results indicated that girls with higher BMI were at an increased risk of developing asthma during the 12-month follow-up. The odds ratios for girls developing physician-diagnosed asthma were 1.75 (95% CI = 1.18-2.61 and 1.12 (95% CI = 0.76-1.67, respectively, for overweight and obesity as compared to the normal weight reference group after adjustment for other covariates. A similar relationship was not observed for overweight and obese boys who were also significantly more active than their female counterparts. Conclusions Increased BMI exaggerates the risk of acquiring asthma in symptomatic adolescent females but not in adolescent males. Thus, gender is an important modifier of BMI-related asthma risk. Additional research will be required to determine whether the increased asthma risk results from genetic, physiological or behavioural differences.

Protection of nuclear power plants against external events

International Nuclear Information System (INIS)

Suetterlin, L.

1978-01-01

The different aspects for the selection of external events to be accounted for in designing nuclear power plants and in defining load assumptions are illustrated: 1) In case of earthquake the severest possible events according to the state of science and technology are assumed. 2) For events where it is not or only to a certain extent possible to apply this method, e.g. in the load case airplane crash, load assumptions are defined in a combined probabilitic-deterministic way. By the example of plant protection, it is shown that by integrating all measures for protecting against interference of third parties (sabotage) or other external events, optimum protection concepts may be achieved. In all considerations on interference of third parties or other external events, one has to take into account that absolute protection is not possible. Nevertheless, it may be confirmed that nuclear power plants not only have a much higher level of protection than other, non-nuclear plants with equal or even higher potential hazard, but also that they meet the requirement not to increase significantly the current risk of society. (orig./HP) [de

Scanning the business external environment for information: evidence from Greece

Directory of Open Access Journals (Sweden)

L. Kourteli

2005-01-01

Full Text Available Introduction. This paper examines the business external environment scanning theory for information in the context of Greece. Method. A questionnaire was developed to explore the relationships between general and task business environment, perceived uncertainty, scanning strategy, and sources of information with respect to type of environment, size and industry.The research was based on a sample of 144 private organizations operating in North Greece. Analysis. Data collected were analysed using SPSS. The statistical procedures of chi-squared homogeneity test, ANOVA, Duncan's test of homogeneity of means, and related samples t-test were followed for testing the hypotheses developed. Results. The results show that perceived uncertainty of the general and task business external environment factors depend on the type of the environment, size of organization, and industry where the organizations operate; organizations adapt their scanning strategy to the complexity of the environment; personal sources of information seem to be more important than impersonal sources; external sources of information are equally important with internal sources; and higher levels of environmental uncertainty are associated with higher levels of scanning the various sources. Conclusion. Business external environment scanning of information is influenced by the characteristics of the organizations themselves and by the characteristics of the external environment within which the organizations operate. The study contributes to both environmental scanning theory and has important messages for practitioners.

Accuracy of nurse documentation of delirium symptoms in medical charts.

Science.gov (United States)

Voyer, Philippe; Cole, Martin G; McCusker, Jane; St-Jacques, Sylvie; Laplante, Johanne

2008-04-01

The purpose of this study undertaken in an acute care hospital was to evaluate sensitivity and specificity of the documentation of nurse-reported delirium symptoms in medical charts. This is a descriptive study based on the clinical assessments of a study nurse and nursing notes in the medical charts of 226 delirious older patients newly admitted to an acute care hospital. The results of this prospective validation study indicated that documentation of delirium symptoms is poor. Disorientation, agitation and altered level of consciousness were the three symptoms yielding a higher level of sensitivity, but even so said symptoms were reported in less than a third of the medical charts. Univariate analysis suggested that higher comorbidity level, more severe symptoms of delirium and the use of physical restraints were associated with more valid documentation of delirium symptoms in medical charts. Lastly, this study corroborates results of previous studies, indicating that documentation of delirium symptoms in medical charts can be improved. Future study should target improving nurse documentation of delirium symptoms in medical charts.

Examining the dimensional structure models of secondary traumatic stress based on DSM-5 symptoms.

Science.gov (United States)

Mordeno, Imelu G; Go, Geraldine P; Yangson-Serondo, April

2017-02-01

Latent factor structure of Secondary Traumatic Stress (STS) has been examined using Diagnostic Statistic Manual-IV (DSM-IV)'s Posttraumatic Stress Disorder (PTSD) nomenclature. With the advent of Diagnostic Statistic Manual-5 (DSM-5), there is an impending need to reexamine STS using DSM-5 symptoms in light of the most updated PTSD models in the literature. The study investigated and determined the best fitted PTSD models using DSM-5 PTSD criteria symptoms. Confirmatory factor analysis (CFA) was conducted to examine model fit using the Secondary Traumatic Stress Scale in 241 registered and practicing Filipino nurses (166 females and 75 males) who worked in the Philippines and gave direct nursing services to patients. Based on multiple fit indices, the results showed the 7-factor hybrid model, comprising of intrusion, avoidance, negative affect, anhedonia, externalizing behavior, anxious arousal, and dysphoric arousal factors has excellent fit to STS. This model asserts that: (1) hyperarousal criterion needs to be divided into anxious and dysphoric arousal factors; (2) symptoms characterizing negative and positive affect need to be separated to two separate factors, and; (3) a new factor would categorize externalized, self-initiated impulse and control-deficit behaviors. Comparison of nested and non-nested models showed Hybrid model to have superior fit over other models. The specificity of the symptom structure of STS based on DSM-5 PTSD criteria suggests having more specific interventions addressing the more elaborate symptom-groupings that would alleviate the condition of nurses exposed to STS on a daily basis. Copyright © 2016 Elsevier B.V. All rights reserved.

Reciprocity Between Parental Psychopathology and Oppositional Symptoms From Preschool to Middle Childhood.

Science.gov (United States)

Antúnez, Zayra; de la Osa, Nuria; Granero, Roser; Ezpeleta, Lourdes

2018-03-01

Oppositional defiant disorder (ODD) is a common disorder in preschool children. Evidence indicates that maternal and paternal psychopathology, particularly aggressive behavior and anxious and depressed symptoms, contributes to the development of this disorder. The latest research also suggests that ODD symptoms may exacerbate the mental health problems of parents. Our aim was to establish the existence of a reciprocal association between paternal and maternal psychopathology (aggression, depression, and anxiety) and child ODD at ages 3 and 8, using a longitudinal design in a community sample of preschoolers. The sample included 331 children evaluated at ages 3 and 8 through questionnaires and a semistructured diagnostic interview with parents. Parents also informed about their own psychopathology. At 3 years of age, higher levels of ODD symptoms in girls were concurrently associated with maternal anxious and depressed symptoms and paternal aggressive behavior, and higher levels of ODD symptoms in boys were concurrently associated with maternal aggressive behavior. Longitudinally, for boys, higher levels of maternal anxious and depressed symptoms at child age 3 predicted increases in ODD symptoms from 3 to 8 years of age. In addition, higher levels of ODD symptoms in boys aged 3-8 years predicted increases in fathers' anxious and depressive symptoms. Children with ODD should be evaluated and treated promptly, but efforts should be extended to their parents. Mothers' and fathers' mental health must be explored because the psychopathologies of children and parents reciprocally affect each other. © 2017 Wiley Periodicals, Inc.

Comparison of Psychopathological Symptoms in Adolescents Who Experienced Sexual Violence as a Victim and/or as a Perpetrator.

Science.gov (United States)

Ohlert, Jeannine; Seidler, Corinna; Rau, Thea; Fegert, Jörg; Allroggen, Marc

2017-01-01

Research on sexual violence victims and perpetrators indicates that victims in general are found to report higher levels of psychopathological symptoms, especially internalizing behavior, whereas perpetrators often show externalizing behavior. Little is known, however, about the psychopathology of perpetrators of sexual violence who have also experienced sexual victimization (victim-perpetrators). Thus, the aim of the current study was to examine this group within a sample of adolescents living in residential care or federal boarding schools. Participants reported their lifetime experience with sexual violence (both as victim and perpetrator) and completed the Youth Self Report. Results indicate that all three groups of adolescents with sexual violence experience report higher total problem scores than adolescents without this experience. Victim-perpetrators show results more similar to those of perpetrators only than those of victims only. The discussion deals with the implications of our findings for the treatment of victims of sexual violence.

Regulating multiple externalities

DEFF Research Database (Denmark)

Waldo, Staffan; Jensen, Frank; Nielsen, Max

2016-01-01

Open access is a well-known externality problem in fisheries causing excess capacity and overfishing. Due to global warming, externality problems from CO2 emissions have gained increased interest. With two externality problems, a first-best optimum can be achieved by using two regulatory instrume......Open access is a well-known externality problem in fisheries causing excess capacity and overfishing. Due to global warming, externality problems from CO2 emissions have gained increased interest. With two externality problems, a first-best optimum can be achieved by using two regulatory...

Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims.

Science.gov (United States)

Soberón, Carmen; Crespo, María; Del Mar Gómez-Gutiérrez, María; Fernández-Lansac, Violeta; Armour, Cherie

2016-01-01

Confirmatory factor analytic studies have shown that posttraumatic stress disorder (PTSD) symptoms included in the fifth edition of the Diagnostic and Statistical Manual Disorders (DSM-5) may be better explained by two 6-factor models (the Externalizing Behaviours model and the Anhedonia model) and a 7-factor Hybrid model. The latter model comprises the symptom clusters of intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, and anxious and dysphoric arousal. This model has received empirical support mainly in American samples. Of note, there have been a limited number of studies conducted on samples from other countries. This study aimed to examine the underlying dimensionality of DSM-5 PTSD symptoms in a Spanish clinical sample exposed to a range of traumatic events. Participants included 165 adults (78.8% females) seeking treatment in trauma services in the Madrid area (Spain). PTSD was assessed using the Global Assessment of Posttraumatic Stress Scale 5, a Spanish self-report instrument assessing posttraumatic symptoms according to the DSM-5 criteria. Confirmatory factor analyses were conducted in Mplus. Both the 7-factor Hybrid model and the 6-factor Anhedonia model demonstrated good and equivalent fit to the data. The findings of this study replicate and extend previous research by providing support for both the 7-factor Hybrid model and the 6-factor Anhedonia model in a clinical sample of Spanish trauma survivors. Given equivalent fit for these two models and the fewer number of latent factors in the Anhedonia model, it was selected as optimal in a traumatized Spanish sample. Implications and future research directions are discussed.

Developmental Pathways from Child Maltreatment to Adolescent Substance Use: The Roles of Posttraumatic Stress Symptoms and Mother-Child Relationships

Science.gov (United States)

Yoon, Susan; Kobulsky, Julia M.; Yoon, Dalhee; Kim, Wonhee

2018-01-01

While many studies have identified a significant relation between child maltreatment and adolescent substance use, the developmental pathways linking this relation remain sparsely explored. The current study examines posttraumatic stress (PTS) symptoms, mother-child relationships, and internalizing and externalizing problems as potential longitudinal pathways through which child maltreatment influences adolescent substance use. Structural equation modeling was conducted on 883 adolescents drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). The pathways of PTS symptoms linked physical and sexual abuse to substance use, and the pathways of mother-child relationships linked emotional abuse and neglect to substance use. None of the four types of maltreatment affected substance use via internalizing or externalizing problems. The findings suggest that intervention efforts aimed at addressing posttraumatic stress symptoms and improving mother-child relationship quality may be beneficial in reducing substance use among adolescents with child maltreatment histories. PMID:29503490

Social phobia symptoms: prevalence, sociodemographic correlates, and overlap with specific phobia symptoms.

Science.gov (United States)

Iancu, Iulian; Levin, Jennifer; Hermesh, Haggai; Dannon, Pinhas; Poreh, Amir; Ben-Yehuda, Yoram; Kaplan, Zeev; Marom, Sofi; Kotler, Moshe

2006-01-01

Social phobia (SP) is a highly prevalent disorder in Western countries, but is rather rare in Eastern societies. Prevalence rates range from 0.5% in Eastern samples up to 16% in Western studies. Its prevalence in Israel, an Asian state characterized by Western culture, has not yet been studied. The present study aimed to assess the prevalence of SP symptoms in a nonclinical sample of Israeli adolescents, to characterize sociodemographic correlates of SP symptoms and to evaluate comorbidity with specific phobia symptoms. Participants included 850 young soldiers from the Israel Defense Forces. Measures included the Liebowitz Social Anxiety Scale (LSAS; self-report version), a questionnaire on specific fears and phobias, and a sociodemographic questionnaire. Clinical and demographic correlates of SP were also examined. Probable SP (LSAS >or=80) was present in 4.5% of the sample. Overall, SP symptoms were reported by a great percentage of the subjects, as displayed by the rather high mean LSAS scores (29; SD = 23.79) in this nonclinical sample. The following variables were accompanied by higher LSAS scores according to our regression model: inability to perform command activities, receiving psychotropic medication before army service, having less than two friends, shy family members, and treatment during military service. Subjects with probable SP had a rate of comorbidity with specific phobia symptoms of 44%. Our findings corroborate those from other studies in Western countries, both regarding the high prevalence of SP symptoms and its demographic and clinical correlates, as well as regarding the high overlap rate with specific phobia symptoms.

Low hair cortisol concentration and emerging attention-deficit/hyperactivity symptoms in preschool age.

Science.gov (United States)

Schloß, Susan; Ruhl, Isabelle; Müller, Viola; Becker, Katja; Skoluda, Nadine; Nater, Urs M; Pauli-Pott, Ursula

2018-03-23

Previous research demonstrated hypoactivity of the HPA axis in children with attention-deficit/hyperactivity disorder (ADHD) or externalizing symptoms. We analyzed the predictive association between the long-term HPA axis activity and increasing symptoms of ADHD in the preschool period. The sample consisted of n = 125 4-year-old children and their families (including n = 64 children with elevated ADHD symptoms). ADHD symptoms were assessed by a structured clinical interview with the mother and by parent- and teacher-report questionnaires. The long-term HPA axis activity was assessed by the hair cortisol concentration (HCC) (over a 3-month period). After controlling for potential confounders, low HCC predicted an increase in ADHD symptoms between the age of 4 and 5 years. Exploration of gender effects revealed that cross-sectional and predictive associations were significant in boys but not in girls. Low HCC might thus be regarded as an early marker of a possibly gender-related developmental pathway to ADHD. © 2018 Wiley Periodicals, Inc.

Construct validation of the hybrid model of posttraumatic stress disorder: Distinctiveness of the new symptom clusters.

Science.gov (United States)

Silverstein, Madison W; Dieujuste, Nathalie; Kramer, Lindsay B; Lee, Daniel J; Weathers, Frank W

2018-03-01

Despite the factor analytic support for the seven-factor hybrid model (Armour et al., 2015) of posttraumatic stress disorder (PTSD), little research has examined the degree to which newly established symptom clusters (i.e., negative affect, anhedonia, dysphoric arousal, anxious arousal, externalizing behavior) functionally and meaningfully differ in their associations with other clinical phenomena. The aim of the current study was to examine the degree to which newly established PTSD symptom clusters differentially relate to co-occurring psychopathology and related clinical phenomena through Wald testing using latent variable modeling. Participants were 535 trauma-exposed undergraduates who completed the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5; Weathers et al., 2013) and Personality Assessment Inventory (PAI; Morey, 1991). As expected and in line with results from previous studies, significant heterogeneity emerged for dysphoric arousal, anxious arousal, and externalizing behavior. However, there was less evidence for the distinctiveness of negative affect and anhedonia. Results indicate that only some of the newly established symptom clusters significantly differ in their associations with related clinical phenomena and that the hybrid model might not provide a meaningful framework for understanding which PTSD symptoms relate to associated features. Limitations include a non-clinical sample and reliance on retrospective self-report assessment measures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Approaches in estimation of external cost for fuel cycles in the ExternE project

International Nuclear Information System (INIS)

Afanas'ev, A.A.; Maksimenko, B.N.

1998-01-01

The purposes, content and main results of studies realized within the frameworks of the International Project ExternE which is the first comprehensive attempt to develop general approach to estimation of external cost for different fuel cycles based on utilization of nuclear and fossil fuels, as well as on renewable power sources are discussed. The external cost of a fuel cycle is treated as social and environmental expenditures which are not taken into account by energy producers and consumers, i.e. these are expenditures not included into commercial cost nowadays. The conclusion on applicability of the approach suggested for estimation of population health hazards and environmental impacts connected with electric power generation growth (expressed in money or some other form) is made

In Iranian female and male adolescents, romantic love is related to hypomania and low depressive symptoms, but also to higher state anxiety.

Science.gov (United States)

Bajoghli, Hafez; Joshaghani, Narges; Gerber, Markus; Mohammadi, Mohammad-Reza; Holsboer-Trachsler, Edith; Brand, Serge

2013-06-01

Experiencing romantic love is important in individual development. Little is known about romantic love among adolescents in non-Western countries. The aim of the present study was to explore romantic love among Iranian male and female adolescents. A total of 201 adolescents (mean age: 17.73 years) took part in the study; of these, 81 indicated they were experiencing romantic love at the time of survey, and 120 indicated they were not in love. Participants answered questionnaires related to affective states (hypomania, depressive symptoms, state and trait anxiety) and exercise, and completed a sleep log for seven consecutive nights. Compared to controls, participants in love displayed favourable hypomania scores, fewer depressive symptoms and increased concentration during the day. However, participants in love also had higher state anxiety scores. Moreover, hypomanic-like stages increased with duration of relationship in female, but not in male participants. The pattern of results suggests a favourable association between being currently in love and emotional and cognitive processes. Sleep, however, seemed unrelated to this specific state.

Esophageal stasis in achalasia patients without symptoms after treatment does not predict symptom recurrence.

Science.gov (United States)

van Hoeij, F B; Smout, A J P M; Bredenoord, A J

2017-08-01

After achalasia treatment, a subset of patients has poor esophageal emptying without having symptoms. There is no consensus on whether to pre-emptively treat these patients. We hypothesized that, if left untreated, these patients will experience earlier symptom recurrence than patients without stasis. 99 treated achalasia patients who were in clinical remission (Eckardt ≤3) at 3 months after treatment were divided into two groups, based on presence or absence of esophageal stasis on a timed barium esophagogram performed after 3 months. Two years after initial treatment, patients with stasis after treatment still had a wider esophagus (3 cm; IQR: 2.2-3.8) and more stasis (3.5 cm; IQR: 1.9-5.6) than patients without stasis (1.8 cm wide and 0 cm stasis; both Ptreatment also had a higher degree of stasis and a more dilated esophagus, compared to patients without stasis, they did not have a higher chance of requiring retreatment. We conclude that stasis in symptom-free achalasia patients after treatment does not predict treatment failure within 2 years and can therefore not serve as a sole reason for retreatment. © 2017 John Wiley & Sons Ltd.

Prognostic value of bone involvement in patients with squamous cell carcinoma of the external and middle ear

International Nuclear Information System (INIS)

Shiga, Hideaki; Ito, Makoto; Uramoto, Naoki; Hatano, Miyako; Miwa, Takaki; Furukawa, Mitsuru

2007-01-01

The incidence of the external and middle ear squamous cell carcinoma (SCC) is extremely rare in the head and neck cancer with less than 1%. Therefore, the correlation between the staging classification and the prognosis has not been clear. Prognostic factors for patients with the external and middle ear SCC were assessed in the initial clinical symptoms and radiographic imaging. 13 patients with the external and middle ear SCC (5 male and 8 female) that had been treated at the Department of Otorhinolaryngology, Kanazawa University hospital from 2000 to 2006 were selected for this study. The radiation therapy followed surgery in ten patients. One patient received the radical cure irradiation before surgery. Two patients received a surgical excision alone. The temporal bone involvement and the parotid gland involvement in the radiographic image (computed tomography imaging and/or magnetic resonance imaging) were assessed. Clinical symptoms (otalgia, hearing disturbance, tinnitus, vertigo and facial nerve palsy) before treatment were reviewed based on the medical record. The correlation of those clinical factors and T staging in the Pittsburgh classification with overall survival was statistically assessed. The temporal bone involvement significantly correlated with worse prognosis. However, parotid gland involvement did not influence the prognosis. Moreover, statistically significant difference in T staging of the Pittsburgh classification (T1·T2 vs. T3·T4) was not found. The temporal bone involvement in the radiographic image was a prognostic factor for patients with the external and middle ear SCC. Pittsburgh classification needs to be modified because the bony part of the external auditory canal involvement is considered as T2 stage and the soft tissue involvement is defined as T4 stage. (author)

Quality of Higher Education

DEFF Research Database (Denmark)

Zou, Yihuan

is about constructing a more inclusive understanding of quality in higher education through combining the macro, meso and micro levels, i.e. from the perspectives of national policy, higher education institutions as organizations in society, individual teaching staff and students. It covers both......Quality in higher education was not invented in recent decades – universities have always possessed mechanisms for assuring the quality of their work. The rising concern over quality is closely related to the changes in higher education and its social context. Among others, the most conspicuous...... changes are the massive expansion, diversification and increased cost in higher education, and new mechanisms of accountability initiated by the state. With these changes the traditional internally enacted academic quality-keeping has been given an important external dimension – quality assurance, which...

Predicting asthma in preschool children with asthma symptoms: study rationale and design

Directory of Open Access Journals (Sweden)

Hafkamp-de Groen Esther

2012-10-01

Full Text Available Abstract Background In well-child care it is difficult to determine whether preschool children with asthma symptoms actually have or will develop asthma at school age. The PIAMA (Prevention and Incidence of Asthma and Mite Allergy Risk Score has been proposed as an instrument that predicts asthma at school age, using eight easy obtainable parameters, assessed at the time of first asthma symptoms at preschool age. The aim of this study is to present the rationale and design of a study 1 to externally validate and update the PIAMA Risk Score, 2 to develop an Asthma Risk Appraisal Tool to predict asthma at school age in (specific subgroups of preschool children with asthma symptoms and 3 to test implementation of the Asthma Risk Appraisal Tool in well-child care. Methods and design The study will be performed within the framework of Generation R, a prospective multi-ethnic cohort study. In total, consent for postnatal follow-up was obtained from 7893 children, born between 2002 and 2006. At preschool age the PIAMA Risk Score will be assessed and used to predict asthma at school age. Discrimination (C-index and calibration will be assessed for the external validation. We will study whether the predictive ability of the PIAMA Risk Score can be improved by removing or adding predictors (e.g. preterm birth. The (updated PIAMA Risk Score will be converted to the Asthma Risk Appraisal Tool- to predict asthma at school age in preschool children with asthma symptoms. Additionally, we will conduct a pilot study to test implementation of the Asthma Risk Appraisal Tool in well-child care. Discussion Application of the Asthma Risk Appraisal Tool in well-child care will help to distinguish preschool children at high- and low-risk of developing asthma at school age when asthma symptoms appear. This study will increase knowledge about the validity of the PIAMA risk score and might improve risk assessment of developing asthma at school age in (specific subgroups

Is lower symptom recognition associated with socioeconomic inequalities in help-seeking for potential breast cancer symptoms?

Science.gov (United States)

Davies, Hilary; Marcu, Afrodita; Vedsted, Peter; Whitaker, Katriina L

2018-02-01

Socioeconomic inequalities in recognising signs and symptoms of cancer may result in inequalities in timely help-seeking and subsequent prognosis of breast cancer. We explored the mediating role of symptom attribution and concern on the relationship between level of education and help-seeking for potential breast cancer symptoms. Women aged ≥47 years (n = 961) were purposively recruited (by education) to complete an online vignette-based survey that included nipple rash and axillary lump (in separate vignettes) as potential symptoms of breast cancer. Women completed questions relating to medical help-seeking (yes/no), cancer attribution, symptom concern, cancer avoidance, family history, and demographics. Women with low education and mid education attributed nipple rash less often to cancer (26% and 27% mentioned cancer) than women with a degree or higher (40%). However, women with a degree or higher (63%) or mid education (64%) were less likely to anticipate seeking help for the nipple rash than women with no formal qualifications (73%). This association was statistically significant in the 60- to 69-year-old age group. There was no significant association between education and help-seeking for axillary lump. Mediation analysis adjusting for potential confounders confirmed that the association between education and help-seeking for nipple rash was fully mediated by symptom concern. Socioeconomic inequalities in stage at diagnosis and survival of breast cancer may not always be explained by lower likelihood of suspecting cancer and subsequent impact on help-seeking. Reducing inequalities in stage at diagnosis will involve understanding a broader range of bio-psycho-social factors (eg, comorbidities and healthcare system factors). Copyright © 2017 John Wiley & Sons, Ltd.

Globalisation and higher education studies in South Africa | Strydom ...

African Journals Online (AJOL)

Globalisation and higher education studies in South Africa. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... Globalisation and its impact on higher education will be discussed, while globalisation as a critical external influence on the ...

Analysis of External Treatment Methods and Technical Characteristics of External Treatment

Science.gov (United States)

Zhang, Rui; Miao, Mingsan; Bai, Ming

2018-01-01

Chinese medicine external therapy is a treatment method of Chinese medicine with Chinese characteristics. The effect of traditional Chinese medicine external treatment, convenient operation, external treatment and technology has great prospects for development. The traditional Chinese medicine external treatment method and technical characteristics were analyzed.

Efficacy of enhanced external counterpulsation: our experience

Directory of Open Access Journals (Sweden)

Chandra Mani Adhikari

2014-11-01

Full Text Available Aims Enhanced external counterpulsation therapy is a non-invasive, non-pharmacological outpatient treatment option for refractory angina pectoris. Our aim is to evaluate its efficacy in Nepalese refractory angina pectoris patients. Materials and methods It was single centre prospective study conducted from 2010 August to 2013 December. All thirty one (n=31 consecutive patients, referred for and received 35 hours of treatment were included in this study. The distance covered in six minute walk test before and after the treatment was recorded and compared. Patients were followed each with the questionnaires about their anginal symptoms before and after the treatment. Results In our study 19(61.3% were male and 12(38.7% female. The mean age was 65.7±9.3 years. Most patients had multi vessel disease. Twelve patients had previous history of revascularization. In 6 minute walk test there was significant difference in mean distance covered before and after the treatment. Most patients experienced decrease in the angina symptom. They had decreased in severity and frequency of angina, resulting in decreased use of sublingual nitrates. Conclusion EECP can be safe and effective treatment option for patients with RAP.

Associations of Parenting Dimensions and Styles with Externalizing Problems of Children and Adolescents: An Updated Meta-Analysis

Science.gov (United States)

Pinquart, Martin

2017-01-01

The present meta-analysis integrates research from 1,435 studies on associations of parenting dimensions and styles with externalizing symptoms in children and adolescents. Parental warmth, behavioral control, autonomy granting, and an authoritative parenting style showed very small to small negative concurrent and longitudinal associations with…

Higher Prevalence of Frailty Among a Sample of HIV-Infected Middle-aged and Older Chinese Adults Is Associated With Neurocognitive Impairment and Depressive Symptoms.

Science.gov (United States)

Ding, Yingying; Lin, Haijiang; Liu, Xing; Wong, Frank Y; Sun, Yan V; Marconi, Vincent C; He, Na

2017-03-01

We investigated the prevalence and correlates of prefrailty/frailty, determined on the basis of the Fried criteria, in Chinese patients with and those without human immunodeficiency virus (HIV) infection. HIV-infected patients were more likely to be frail or prefrail than controls, and this association remained significant after adjustment for potential confounders (odds ratio, 3.79). After additional adjustment for neurocognitive impairment and depressive and insomnia symptoms, this association remained significant but attenuated (odds ratio, 2.16). In the HIV-infected group, these 3 variables were independently associated with prefrailty/frailty. These findings suggest that neurocognitive impairment and depressive and/or insomnia symptoms may account for a higher prevalence of prefrailty/frailty in HIV-infected patients but require further longitudinal investigation. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Trajectories of Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Symptoms as Precursors of Borderline Personality Disorder Symptoms in Adolescent Girls

Science.gov (United States)

Stepp, Stephanie D.; Burke, Jeffrey D.; Hipwell, Alison E.; Loeber, Rolf

2011-01-01

Little empirical evidence exists regarding the developmental links between childhood psychopathology and borderline personality disorder (BPD) in adolescence. The current study addresses this gap by examining symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) as potential precursors. ADHD and BPD share clinical features of impulsivity, poor self-regulation, and executive dysfunction, while ODD and BPD share features of anger and interpersonal turmoil. The study is based on annual, longitudinal data from the two oldest cohorts in the Pittsburgh Girls Study (N = 1233). We used piecewise latent growth curve models of ADHD and ODD scores from age 8–10 and 10–13 years to examine the prospective associations between dual trajectories of ADHD and ODD symptom severity and later BPD symptoms at age 14 in girls. To examine the specificity of these associations, we also included conduct disorder (CD) and depression symptom severity at age 14 as additional outcomes. We found that higher levels of ADHD and ODD scores at age 8 uniquely predicted BPD symptoms at age 14. Additionally, the rate of growth in ADHD scores from age 10–13 and the rate of growth in ODD scores from 8–10 uniquely predicted higher BPD symptoms at age 14. This study adds to the literature on the early development of BPD by providing the first longitudinal study to examine ADHD and ODD symptom trajectories as specific childhood precursors of BPD symptoms in adolescent girls. PMID:21671009

Palliative external-beam radiotherapy for bone metastases from hepatocellular carcinoma

Institute of Scientific and Technical Information of China (English)

Shinya; Hayashi; Hidekazu; Tanaka; Hiroaki; Hoshi

2014-01-01

The incidence of bone metastases(BMs)from hepatocellular carcinoma(HCC)is relatively low compared to those of other cancers,but it has increased recently,especially in Asian countries.Typically,BMs from HCC appear radiologically as osteolytic,destructive,and expansive components with large,bulky soft-tissue masses.These soft-tissue masses are unique to bone metastases from HCC and often replace the normal bone matrix and exhibit expansive growth.They often compress the peripheral nerves,spinal cord,or cranial nerves,causing not only bone pain but also neuropathic pain and neurological symptoms.In patients with spinal BMs,the consequent metastatic spinal cord compression(MSCC)causes paralysis.Skull base metastases(SBMs)with cranial nerve involvement can cause neurological symptoms.Therefore,patients with bony lesions often suffer from pain or neurological symptoms that have a severe,adverse effect on the quality of life.External-beam radiotherapy(EBRT)can effectively relieve bone pain and neurological symptoms caused by BMs.However,EBRT is not yet widely used for the palliative management of BMs from HCC because of the limited number of relevant studies.Furthermore,the optimal dosing schedule remains unclear,despite clinical evidence to support single-fraction ra-diation schedules for primary cancers.In this review,we outline data describing palliative EBRT for BMs from HCC in the context of(1)bone pain;(2)MSCC;and(3)SBMs.

The inter-relationship of premenstrual symptoms.

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Mira, M; Abraham, S; McNeil, D; Vizzard, J; Macaskill, P; Fraser, I; Llewellyn-Jones, D

1995-09-01

The prospective symptom reports of women seeking treatment for premenstrual symptoms and control subjects was investigated. In order to compare symptom reports from premenstrual symptom sufferers and control subjects a method of combining and analysing prospectively collected menstrual cycle symptom data is required. A technique that uses the time of onset of menses and the time of ovulation (as measured by urinary luteinizing hormone excretion) to standardize each cycle into 14 time points was developed. Summary factors were then empirically derived from data collected prospectively from 30 premenstrual symptom sufferers and 19 control subjects. Twenty-two mood symptoms were summarized into a single factor and the 29 most frequently occurring physical symptoms were summarized into two factors. Factor scores were calculated on the basis of these factors and the effect of time during the menstrual cycle on these scores examined. Both physical symptom factor scores increased significantly in the luteal phase for both the premenstrual symptom sufferer group and the control group. The single mood factor score increased significantly in the luteal phase for the premenstrual sufferer group but not for the control group, suggesting that the only qualitative difference between the groups was the presence of cyclic mood symptoms in the premenstrual symptom sufferer group. The premenstrual symptom sufferer group recorded significantly higher scores on each of the three factors than the control group. The correlation between the scores on each of the factors over three cycles was high both in the follicular and luteal phase suggesting that these factor scores provide a reproducible measure of menstrual cycle symptomatology.

Work-specific cognitive symptoms and the role of work characteristics, fatigue and depressive symptoms in cancer patients during 18 months post return to work.

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Dorland, H F; Abma, F I; Roelen, C A M; Stewart, R; Amick, B C; Bültmann, U; Ranchor, A V

2018-06-19

Cancer patients can experience work-specific cognitive symptoms post return to work (RTW). The study aims to: 1) describe the course of work-specific cognitive symptoms in the first 18 months post RTW, and 2) examine the associations of work characteristics, fatigue and depressive symptoms with work-specific cognitive symptoms over time. This study used data from the 18-months longitudinal "Work Life after Cancer" cohort. The Cognitive Symptom Checklist-Work, Dutch Version (CSC-W DV) was used to measure work-specific cognitive symptoms. Linear mixed models were performed to examine the course of work-specific cognitive symptoms during 18 months follow-up; linear regression analyses with generalised estimating equations (GEE) were used to examine associations over time. Working cancer patients diagnosed with different cancer types were included (n=378). Work-specific cognitive symptoms were stable over 18 months. At baseline, cancer patients reported more working memory symptoms (M=31.9, CI=23.1, 26.4) compared to executive function symptoms (M=19.3; CI=17.6, 20.9). Cancer patients holding a job with both manual and non-manual tasks reported less work-specific cognitive symptoms (unstandardized regression coefficient b=-4.80; CI=-7.76, -1.83) over time, compared to cancer patients with a non-manual job. Over time, higher depressive symptoms were related to experiencing more overall work-specific cognitive symptoms (b=1.27; CI=1.00, 1.55) and a higher fatigue score was related to more working memory symptoms (b=0.13; CI=0.04, 0.23). Job type should be considered when looking at work-specific cognitive symptoms over time in working cancer patients. To reduce work-specific cognitive symptoms, interventions targeted at fatigue and depressive symptoms might be promising. This article is protected by copyright. All rights reserved.

Analgesia/anesthesia for external cephalic version.

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Weiniger, Carolyn F

2013-06-01

Professional society guidelines recommend that women with breech presentation be delivered surgically due to a higher incidence of fetal risks compared with vaginal delivery. An alternative is attempted external cephalic version, which if successful, enables attempted vaginal delivery. Attitudes towards external cephalic version (ECV) will be considered in this review, along with pain relief methods and their impact on ECV success rates. Articles suggest that ECV is infrequently offered, due to both physician and patient factors. Success of ECV is higher in multiparous women, complete breech, posterior placenta, or smaller fetus. Preterm ECV performance does not increase vaginal delivery rates. Neuraxial techniques (spinal or epidural) significantly increase ECV success rates, as do moxibustion and hypnosis. Four reviews summarized studies considering ECV and neuraxial techniques. These reviews suggest that neuraxial techniques using high (surgical) doses of local anesthetic are efficacious compared with control groups not using anesthesia, whereas techniques using low-doses are not. Low-dose versus high-dose neuraxial analgesia/anesthesia has not been directly compared in a single study. Based on currently available data, the rate of cephalic presentation is not increased using neuraxial techniques, but vaginal delivery rates are higher. ECV appears to be a low-risk procedure. The logistics of routine ECV and provision of optimal neuraxial techniques for successful ECV require additional research. Safety aspects of neuraxial anesthesia for ECV require further investigation.

External laryngeal injuries in children--comparison of diagnostic methods.

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Zawadzka-Glos, L; Jakubowska, A; Frackiewicz, M; Brzewski, M

2013-09-01

The injuries of the larynx constitute around 1% of all injuries. The great majority of the injuries of the larynx happens during playing. The effects of these injuries may appear insignificant however, not always the direct clinical symptoms correlate with the degree of respiratory tract failure. The symptoms of laryngeal injuries depend on the extension and strength of the trauma and always relate to impair patency of respiratory tract. The aim of the study is to compare two diagnostic methods: laryngoscopy and ultrasonography in evaluation of laryngeal injuries in children. In the Department of Pediatric Otolaryngology, Medical University of Warsaw, in the period between 2004 and 2010 there were hospitalised 15 children with external injury of the larynx. From among 15 hospitalized children, 7 were qualified as not serious trauma and were treated preservatively and the other 8 as sever trauma. The mechanism of traumas was diverse. Dyspnea was a predominating symptom, the others included hoarsness, change in voice quality, even aphonia, pain while speaking and swallowing, cough and hemoptysis. Direct laryngoscopy is a standard in diagnostics of the injuries of the larynx. Ultrasonography of the larynx is recommended in every case of laryngeal injury as an additional non-invasive complementary diagnostic examination. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Associations between fathers’ and mothers’ psychopathology symptoms, parental emotion socialization, and preschoolers’ social-emotional development

NARCIS (Netherlands)

Van der Pol, L.D.; Groeneveld, M.G.; Endendijk, J. J.; van Berkel, S. R.; Hallers-Haalboom, E.T.; Bakermans-Kranenburg, M. J.; Mesman, J.

2016-01-01

In this study we tested whether the relation between fathers’ and mothers’ psychopathology symptoms and child social-emotional development was mediated by parents’ use of emotion talk about negative emotions in a sample of 241 two-parent families. Parents’ internalizing and externalizing problems

Associations Between Fathers’ and Mothers’ Psychopathology Symptoms, Parental Emotion Socialization, and Preschoolers’ Social-Emotional Development

NARCIS (Netherlands)

van der Pol, Lotte D.; Groeneveld, Marleen G.; Endendijk, Joyce J.; van Berkel, Sheila R.; Hallers-Haalboom, Elizabeth T.; Bakermans-Kranenburg, Marian J.; Mesman, Judi

2016-01-01

In this study we tested whether the relation between fathers’ and mothers’ psychopathology symptoms and child social-emotional development was mediated by parents’ use of emotion talk about negative emotions in a sample of 241 two-parent families. Parents’ internalizing and externalizing problems

Prevalence of depressive symptoms in metabolic syndrome

Directory of Open Access Journals (Sweden)

Sonia María López C

2008-06-01

Full Text Available Depression has been related with alterations of glucose metabolism, hypertension, hypercholesterolemia, adiposity and dislipidemias, which constitute the metabolic syndrome (m s. Objective: to determine the frequency of depressive symptoms in patients with m s. Material and methods: an observational, descriptive, transverse study was carried out in 101 patients with m s(69 women and 32 men. The Beck inventory for depression was applied. Vasodilatation in the brachial artery and the thickness of the carotid intimae-media were evaluated by means of ultrasonographic measurement. Abdominal perimeter, trygliceridemia, cholesterolemia and insulin resistance were calculated. The statistic treatment was performed by means of descriptive and inferential through mean, standard deviation, and correlation proofs. Insulin resistance was calculated by the h o m a method. Results:prevalence of depressive symptoms: 46.34% between patients with m s (correlation of 0.42 significative at p = 0.05. A higher number of components of the syndrome correlates with higher severity of the depression. Depressive symptoms were associated to a higher insulin resistance, low levels of c- h d l, hypertension and carotid atherosclerosis. Conclusion: depression has a high prevalence in the m s and its associates with a higher number of metabolic and vascular disturbances

The Brazilian external individual monitoring scenario

International Nuclear Information System (INIS)

Mauricio, Claudia L.P.; Silva, Claudio R. da; Cunha, Paulo G. da

2015-01-01

In order to improve radiation protection it is necessary to have knowledge of the occupational radiation dose levels in all radiation facilities. This information comes from individual monitoring services, which are responsible for measuring and providing information about workers' radiation exposure. In 1981, the Comissao Nacional de Energia Nuclear (CNEN) of Brazil starts to develop a comprehensive system for regulation and storage of occupational radiation dose. This paper starts with an overview of the evolution of the Brazilian authorization and data storage system for external individual monitoring. It starts with a rule for authorization of all Brazilian photon individual monitoring services and the obligation for them to send the measured dose to CNEN. Up to now there is no regulation for neutron individual monitoring. The aim of this paper is to present the current scenario of the Brazilian external monitoring system, reinforcing its importance and remaining problems. The number of monitored workers greatly increases every year, having surpassed 150,000 people monitored. The stored data show that the mean annual occupational external dose is decreasing from 2.4 mSv in 1987 to about 0.6 mSv, in 2012, but there is still some not realistic very high dose measured (higher than 100 mSv), without investigation. About 80% of the annual dose values are lower than the monthly register level. As expected, the higher real photon doses are found in Nuclear Medicine, Industrial Radiology and Interventional Radiology. All recorded annual neutron dose values are lower than 20 mSv. (author)

Depressive symptoms and diabetes control in African Americans.

Science.gov (United States)

Wagner, Julie A; Abbott, Gina L; Heapy, Alicia; Yong, Lynne

2009-02-01

This study of African Americans with diabetes investigated: (1) the relationship between depressive symptoms and glycemic control; (2) the relationship between depressive symptoms and long-term diabetes complications; (3) the relationship between depressive symptoms and medication usage; and (4) the effects of demographic and diabetes variables on these relationships. One-hundred twenty five African American diabetic adults who were attending health fairs reported demographic and medical history and provided blood samples for A1c assessment of glycemic control. They also completed the Centers for Epidemiological Studies Depression questionnaire, and the Diabetes Self-Care Inventory. After controlling for confounders, higher depressive symptoms were associated with higher A1c, more long-term diabetes complications, and more diabetes medications. Diabetes self-care did not fully account for these relationships. The relationship between depression and poor diabetes control exists in African Americans as it does in Whites. Providers are encouraged to attend to depression in their African American patients with diabetes.

OMERACT-based fibromyalgia symptom subgroups: an exploratory cluster analysis.

Science.gov (United States)

Vincent, Ann; Hoskin, Tanya L; Whipple, Mary O; Clauw, Daniel J; Barton, Debra L; Benzo, Roberto P; Williams, David A

2014-10-16

The aim of this study was to identify subsets of patients with fibromyalgia with similar symptom profiles using the Outcome Measures in Rheumatology (OMERACT) core symptom domains. Female patients with a diagnosis of fibromyalgia and currently meeting fibromyalgia research survey criteria completed the Brief Pain Inventory, the 30-item Profile of Mood States, the Medical Outcomes Sleep Scale, the Multidimensional Fatigue Inventory, the Multiple Ability Self-Report Questionnaire, the Fibromyalgia Impact Questionnaire-Revised (FIQ-R) and the Short Form-36 between 1 June 2011 and 31 October 2011. Hierarchical agglomerative clustering was used to identify subgroups of patients with similar symptom profiles. To validate the results from this sample, hierarchical agglomerative clustering was repeated in an external sample of female patients with fibromyalgia with similar inclusion criteria. A total of 581 females with a mean age of 55.1 (range, 20.1 to 90.2) years were included. A four-cluster solution best fit the data, and each clustering variable differed significantly (P FIQ-R total scores (P = 0.0004)). In our study, we incorporated core OMERACT symptom domains, which allowed for clustering based on a comprehensive symptom profile. Although our exploratory cluster solution needs confirmation in a longitudinal study, this approach could provide a rationale to support the study of individualized clinical evaluation and intervention.

Alcohol, cannabis, nicotine, and caffeine use and symptom distress in schizophrenia.

Science.gov (United States)

Hamera, E; Schneider, J K; Deviney, S

1995-09-01

The high prevalence of substance use, e.g., alcohol and illegal and nonprescribed drugs, in schizophrenia is widely recognized. One explanation for this high prevalence is that substance use may be a self-initiated method for managing symptoms. To test whether the intake of four substances--alcohol, cannabis, nicotine, and caffeine--would increase with increases in symptom distress, daily self-reports of symptom distress and substance intake over 12 weeks were analyzed with pooled time series analyses. Compliance with neuroleptic medication was added to the analyses to control for any changes in prescribed medication compliance while using nonprescribed drugs or alcohol. Of the four substances studied, only nicotine was significantly related to symptom distress. Higher distress with prodromal symptoms was related to decreases in nicotine use. Analysis of caffeine did not meet the criteria for significance but does provide direction for further research. Higher distress, with neurotic symptoms, was related to increases in caffeine use. Further research is needed to clarify the relationship between nicotine and symptoms.

Celiac symptoms in patients with fibromyalgia: a cross-sectional study.

Science.gov (United States)

García-Leiva, Juan Miguel; Carrasco, Jorge Luis Ordóñez; Slim, Mahmoud; Calandre, Elena P

2015-03-01

Fibromyalgia is a chronic pain syndrome associated with numerous somatic symptoms including gastrointestinal manifestations of nonspecific nature. Celiac disease and nongluten sensitivity frequently evolve in adults with gastrointestinal and extraintestinal symptoms similar to those found among patients with fibromyalgia. The objective of the present study was to evaluate the presence of celiac-type symptoms among patients with fibromyalgia in comparison with healthy subjects and with those experienced by adult celiac patients and subjects with gluten sensitivity. A list of typical celiac-type symptoms was developed, comparing the frequency of presentation of these symptoms between patients with fibromyalgia (N = 178) and healthy subjects (N = 131), in addition to those of celiac patients and gluten-sensitive patients reported in the literature. The frequency of presentation of every celiac-type symptom, excepting anemia, was significantly higher among patients with fibromyalgia compared to controls (p symptoms and cutaneous lesions predominated among patients with fibromyalgia, whereas the prevalence of gastrointestinal symptoms was higher among patients with fibromyalgia compared to gluten-sensitive patients and was similar among patients with fibromyalgia and celiac disease patient. The symptomatological similarity of both pathologies, especially gastrointestinal symptoms, suggests that at least a subgroup of patients with fibromyalgia could experience subclinical celiac disease or nonceliac gluten intolerance.

Preschool children with externalizing behaviors: experience of fathers and mothers.

Science.gov (United States)

Baker, B L; Heller, T L

1996-08-01

Childhood behavior disorders are related to family stress and maladjustment. Little is known, however, about the adjustment of families with preschool-aged children at risk for subsequent behavior disorders. Moreover, fathers' perceptions of child problem behavior and their reactions to it generally have been neglected. Subjects were mothers and fathers of 52 preschool-aged children assigned to one of three groups: control, moderate externalizing, and high externalizing. Higher child externalizing behavior was associated with greater negative family impact, lowered parenting sense of efficacy, and child-rearing practices that were more authoritarian and less authoritative. Mothers and fathers did not differ in actual perceived level of child behavior problems, although both believed that mothers saw more problems. Child Group x Parent interactions indicated that mothers experienced increased stress and a need for help with moderate as well as high child externalizing behaviors, whereas fathers were not elevated on these measures unless the child's externalizing behaviors were high. Implications of these findings for early family intervention are considered.

ExternE: Externalities of energy Vol. 5. Nuclear

International Nuclear Information System (INIS)

Dreicer, M.; Tort, V.; Manen, P.

1995-01-01

Since the early 1970s, there has been increased interest in the environmental impacts that are caused by the generation of electricity. The comparative risk assessment studies at that time used mainly deaths and injuries as impact indicators. By the end of the 1980s studies changed to the assessment of the costs imposed on society and the environment that were not included in the market price of the energy produced, the so-called external costs. The preliminary studies that were published set the conceptual basis, grounded in neo-classical economics, for the valuation of the health and environmental impacts that could be assessed. As a consequence of the many questions raised by the methodologies employed by these early studies, Directorate General XII (DG XII) of the Commission of the European Communities established a collaborative research programme with the United States Department of Energy to identify an appropriate methodology for this type of work. Following the completion of this collaboration, the DG XII programme has continued as the ExternE project. The main objective of the work carried out at CEPN was to develop an impact pathway methodology for the nuclear fuel cycle that would be consistent with the methodologies developed for other fuel cycles, without loosing the nuclear-specific techniques required for a proper evaluation. In this way, comparisons between the different fuel cycles would be possible. This report presents the methodology and demonstration of the results in the context of the French nuclear fuel cycle. The United States team at Oak Ridge National Laboratory has previously issued a draft report on the results of their assessment. The French fuel cycle was broken down into 8 separate stages. Reference sites and 1990s technology were chosen to represent the total nuclear fuel cycle, as it exists today. In addition, the transportation of material between the sites was considered. The facilities are assessed for routine operation, except

Menopausal symptoms: do life events predict severity of symptoms in peri- and post-menopause?

Science.gov (United States)

Pimenta, Filipa; Leal, Isabel; Maroco, João; Ramos, Catarina

2012-08-01

Hormonal changes during menopausal transition are linked to physical and psychological symptoms' emergence. This study aims to explore if life events predict menopausal symptoms. This cross-sectional research encompasses a community sample of 992 women who answered to socio-demographic, health, menopause-related and lifestyle questionnaires; menopausal symptoms and life events were assessed with validated instruments. Structural equation modeling was used to build a causal model. Menopausal status predicted only three symptoms: skin/facial hair changes (β=.136; p=.020), sexual (β=.157; p=.004) and, marginally, vasomotor symptoms (β=.094; p=.054). Life events predicted depressive mood (β=-.391; p=.002), anxiety (β=-.271; p=.003), perceived cognitive impairment (β=-.295; p=.003), body shape changes (β=-.136; p=.031), aches/pain (β=-.212; p=.007), skin/facial hair changes (β=-.171; p=.021), numbness (β=-.169; p=.015), perceived loss of control (β=-.234; p=.008), mouth, nails and hair changes (β=-.290; p=.004), vasomotor (β=-.113; p=.044) and sexual symptoms (β=-.208; p=.009). Although women in peri- and post-menopausal manifested higher symptoms' severity than their pre-menopausal counterparts, only three of the menopausal symptoms assessed were predicted by menopausal status. Since the vast majority of menopausal symptoms' severity was significantly influenced by the way women perceived their recent life events, it is concluded that the symptomatology exacerbation, in peri- and post-menopausal women, might be due to life conditions and events, rather than hormonal changes (nonetheless, the inverse influence should be investigated in future studies). Therefore, these should be accounted for in menopause-related clinical and research settings. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

ExternE: Externalities of energy Vol. 4. Oil and gas

International Nuclear Information System (INIS)

Friedrich, R.; Krewitt, W.; Mayerhofer, P.

1995-01-01

Awareness of the environmental damage resulting from human activity, particularly commencing energy use, has grown greatly in recent years. Effects such as global warming, ozone depletion and acid rain are now the subjects of much research and public debate. It is now known that these and other effects damage a wide range of receptors, including human health, forests, crops, freshwater ecosystems and buildings. Such damages are typically not accounted for by the producers and consumers of the good in question (in this case energy). They are thus referred to as 'external costs' or 'externalities', to distinguish them from the private costs which account for the construction of plant, cost of fuel, wages, etc. In recent years there has been a growing interest in the assessment of the environmental and health impacts of energy, and the related external costs. This concern is driven by a number of different factors: the need to integrate environmental concerns in decision making over the choice between different fuels and energy technologies; the need to evaluate the costs and benefits of stricter environmental standards; increased attention to the use of economic instruments for environmental policy, the need to develop overall indicators of environmental performance of different technologies; major changes in the energy sector, including privatisation, liberalisation of markets, reduction of subsidies, etc. An agreed methodology for calculation and integration of external costs has not been established. Earlier work is typically of a preliminary nature and tends to be deficient with respect to both the methods employed and the quality of models and data used. In consequence of this a collaborative project, the EC/US Fuel Cycles Study, was established between Directorate General XLI (Science, Research and Technology) of the European Commission and the United States Department of Energy. This ran for the period 1991 to 1993, and good agreement on a variety of

Child diurnal cortisol rhythms, parenting quality, and externalizing behaviors in preadolescence.

Science.gov (United States)

Martin, Christina Gamache; Kim, Hyoun K; Bruce, Jacqueline; Fisher, Philip A

2014-02-01

This study examined a neurobiologically informed model of the emergence of child externalizing behaviors in an ethnically diverse community sample of 232 9-12 year old children. Replicating extensive prior research, our analyses revealed that parents' inconsistent discipline and poor quality monitoring were predictive of child externalizing behavior. In addition, poor parental monitoring, but not inconsistent discipline, was associated with children having a significantly flatter morning-to-evening cortisol slope, which was in turn, related to higher levels of externalizing behaviors. An indirect effect of parental monitoring on externalizing behaviors, through child diurnal cortisol rhythms, was also supported. These findings highlight the role of the hypothalamic-pituitary-adrenal (HPA) axis and its hormonal end product, cortisol, in the relationship between the caregiving environment and the development of externalizing behaviors. Copyright © 2013 Elsevier Ltd. All rights reserved.

Are higher blood mercury levels associated with dry eye symptoms in adult Koreans? A population-based cross-sectional study

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Chung, So-Hyang

2016-01-01

Objectives The purpose of this study was to investigate whether blood mercury concentrations associated with the presence of dry eye symptoms in a nationally representative Korean population. Methods Population-based prospective cross-sectional study using the heavy metal data set of the 2010–2012 Korean National Health and Nutrition Examination Survey (KNHANES). A total of 4761 adult Koreans were the eligible population in this study. Of the 7162 survey participants, 2401 were excluded because they were mercury levels were measured on the day the participants completed a questionnaire regarding the presence of dry eye symptoms (persistent dryness or eye irritation). The population was divided into low and high groups by median level (4.26 and 2.89 µg/L for males and females, respectively). Results Self-reported dry eye symptoms were present in 13.0% of the cohort. Participants with dry eye symptoms were significantly more likely to have blood mercury levels exceeding the median than those without dry eye symptoms (45.7% vs 51.7%, p=0.021). Logistic regression analysis showed that, after adjusting for age, gender, education, total household income, smoking status, heavy alcohol use, sleep time, perceived stress status, total cholesterol levels and atopy history, dry eye symptoms were significantly associated with blood mercury levels that exceeded the median (reference: lower mercury group; OR, 1.324; 95% CI 1.059 to 1.655; pmercury levels were associated with dry eye symptoms in a nationally representative Korean population. PMID:27121705

Early adolescent symptoms of social phobia prospectively predict alcohol use.

Science.gov (United States)

Dahne, Jennifer; Banducci, Anne N; Kurdziel, Gretchen; MacPherson, Laura

2014-11-01

The current study examined whether social phobia (SP) symptoms in early adolescence prospectively predicted alcohol use through middle adolescence in a community sample of youth. Data from an ongoing longitudinal study (N = 277) of mechanisms of HIV-related risk behaviors in youth were used to assess the extent to which SP symptoms in early adolescence (mean [SD] age = 11.00 years [0.81]) would predict alcohol use across five annual assessment waves. Adolescents completed measures of SP symptoms, depressive symptoms, and alcohol use at each wave. Higher SP symptoms at baseline predicted higher average odds of alcohol consumption during subsequent waves but did not significantly predict an increase in the odds of alcohol use as a function of time. Within a lagged model, SP symptoms measured at a prior assessment point (1 year earlier) predicted greater odds of drinking alcohol at the following assessment point. Importantly, alcohol use did not significantly predict SP symptoms over time. These results suggest that early SP symptoms are an important risk factor for increased odds of subsequent alcohol use. The present findings highlight that elevated SP symptoms place adolescents at risk for early alcohol use. Early interventions targeting SP symptoms may be crucial for the prevention of problematic alcohol use in early to mid-adolescence. Implications for prevention and treatment approaches are discussed.

ADHD-related symptoms, emotional/behavioral problems, and physical conditions in Taiwanese children with epilepsy.

Science.gov (United States)

Tsai, Fang-Ju; Liu, Shu-Tsen; Lee, Chi-Mei; Lee, Wang-Tso; Fan, Pi-Chuan; Lin, Wei-Sheng; Chiu, Yen-Nan; Gau, Susan Shur-Fen

2013-07-01

Little is known about whether Asian children with epilepsy have more attention-deficit hyperactivity disorder (ADHD)-related symptoms, emotional/ behavioral problems, and physical conditions compared with those described in Western studies. The authors investigated the rates of ADHD-related symptoms, emotional/behavioral problems, and physical conditions among pediatric patients with epilepsy. We recruited 61 patients with epilepsy, aged 6-16 years, and 122 age-, sex-, and parental education-matched school controls. Data on demographics, parental reports on the Child Behavior Checklist (CBCL) and Swanson, Nolan, and Pelham, version IV scale (SNAP-IV), and medical records were collected. The average full-scale intelligence quotient of the case group was 95.8. There were 11 (18.0%), 7 (11.5%), 26 (42.6%), and 26 (42.6%) of children with epilepsy ever clinically diagnosed with developmental delay, overt ADHD symptoms, allergies reported by physicians, and behavior problems measured by the CBCL, respectively. Those children with epilepsy had more severe ADHD-related symptoms and a wider range of emotional/behavioral problems than controls (Cohen's d 0.36-0.80). The rate of potential cases of ADHD among children with epilepsy was 24.6%. A history of developmental delay predicted ADHD- related symptoms and internalizing and externalizing problems. Among children with epilepsy, a longer duration of treatment with antiepileptic drugs predicted externalizing problems, and an earlier onset of epilepsy predicted inattention and hyperactivity/impulsivity. Our findings imply that clinicians should assess physical and emotional/behavioral problems among children with epilepsy in order to provide interventions to offset possible adverse psychiatric outcomes. Copyright © 2012. Published by Elsevier B.V.

Genetic and environmental influences on the codevelopment among borderline personality disorder traits, major depression symptoms, and substance use disorder symptoms from adolescence to young adulthood.

Science.gov (United States)

Bornovalova, Marina A; Verhulst, Brad; Webber, Troy; McGue, Matt; Iacono, William G; Hicks, Brian M

2018-02-01

Although borderline personality disorder (BPD) traits decline from adolescence to adulthood, comorbid psychopathology such as symptoms of major depressive disorder (MDD), alcohol use disorder (AUD), and drug use disorders (DUDs) likely disrupt this normative decline. Using a longitudinal sample of female twins (N = 1,763), we examined if levels of BPD traits were correlated with changes in MDD, AUD, and DUD symptoms from ages 14 to 24. A parallel process biometric latent growth model examined the contributions of genetic and environmental factors to the relationships between developmental components of these phenotypes. Higher BPD trait levels predicted a greater rate of increase in AUD and DUD symptoms, and higher AUD and DUD symptoms predicted a slower rate of decline of BPD traits from ages 14 to 24. Common genetic influences accounted for the associations between BPD traits and each disorder, as well as the interrelationships of AUD and DUD symptoms. Both genetic and nonshared environmental influences accounted for the correlated levels between BPD traits and MDD symptoms, but solely environmental influences accounted for the correlated changes between the two over time. Results indicate that higher levels of BPD traits may contribute to an earlier onset and faster escalation of AUD and DUD symptoms, and substance use problems slow the normative decline in BPD traits. Overall, our data suggests that primarily genetic influences contribute to the comorbidity between BPD features and substance use disorder symptoms. We discuss our data in the context of two major theories of developmental psychopathology and comorbidity.

Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims

Directory of Open Access Journals (Sweden)

Carmen Soberón

2016-12-01

Full Text Available Background: Confirmatory factor analytic studies have shown that posttraumatic stress disorder (PTSD symptoms included in the fifth edition of the Diagnostic and Statistical Manual Disorders (DSM-5 may be better explained by two 6-factor models (the Externalizing Behaviours model and the Anhedonia model and a 7-factor Hybrid model. The latter model comprises the symptom clusters of intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, and anxious and dysphoric arousal. This model has received empirical support mainly in American samples. Of note, there have been a limited number of studies conducted on samples from other countries. Objective: This study aimed to examine the underlying dimensionality of DSM-5 PTSD symptoms in a Spanish clinical sample exposed to a range of traumatic events. Method: Participants included 165 adults (78.8% females seeking treatment in trauma services in the Madrid area (Spain. PTSD was assessed using the Global Assessment of Posttraumatic Stress Scale 5, a Spanish self-report instrument assessing posttraumatic symptoms according to the DSM-5 criteria. Confirmatory factor analyses were conducted in Mplus. Results: Both the 7-factor Hybrid model and the 6-factor Anhedonia model demonstrated good and equivalent fit to the data. Conclusions: The findings of this study replicate and extend previous research by providing support for both the 7-factor Hybrid model and the 6-factor Anhedonia model in a clinical sample of Spanish trauma survivors. Given equivalent fit for these two models and the fewer number of latent factors in the Anhedonia model, it was selected as optimal in a traumatized Spanish sample. Implications and future research directions are discussed. Highlights of the article:

Weighing environmental externalities: Let's do it right

International Nuclear Information System (INIS)

Joskow, P.L.

1992-01-01

Should we as a society adopt policies to internalize external environmental costs? Of course we should. But we should do it correctly. State public utility commissions (PUCs) that are using numerical 'externality adders' reflecting global and regional environmental impacts in the resource planning and selection process are doing it wrong. The use of these adders is likely to lead to higher electricity prices without a commensurate improvement in environmental impacts in the resource planning and selection process are doing it wrong. The use of these adders is likely to lead to higher electricity prices without a commensurate improvement in environmental quality. Alternative approaches for dealing with environmental damages or externalities exist that can lead utilities to take account of the environmental costs associated with the generation of electricity more effectively and at lower cost. This article discusses what an externality is and why the use of environmental adders by PUCs in the resource selection process, while well intentioned, is a bad idea. The author discusses how the most egregious errors associated with the use of adders can be corrected if PUCs insist on using them. Finally, he outlines an alternative approach that state PUCs can pursue which will better serve the electricity customers they are supposed to protect and promote a cleaner environment at the lowest reasonable cost. The author emphasizes that this is not a debate about whether or not environmental costs should be factored into the investment and operating decisions of firms that produce pollution. Rather, it is about how it should be done and whether state PUCs are in a particularly good position to do it well, given their expertise, legal authorities, other responsibilities and scarce resources

Pattern of somatic symptoms in anxiety and depression

International Nuclear Information System (INIS)

Shah, M.

2011-01-01

To determine the pattern of somatic symptoms in anxiety and depressive disorders. Design: Cross Sectional Comparative study Place of Study: Department of Psychiatry Military Hospital Rawalpindi. Duration of Study: From May to November 2002. Patients and Methods: Patients were divided in Group I of anxiety and group II of depression. Fifty patients considered in each group by convenience sampling. The organic basis of their symptoms was ruled out. The patterns of their somatic symptoms and other information like educational and economic status were recorded on Semi Structured Proforma. The patient's diagnosis was made on schedule based ICD-10 research criteria. The severity of anxiety and depression was assessed by using HARS and HDRS respectively. The pattern of somatic symptoms in both groups was then analyzed by the urdu version of Bradford Somatic Inventory. Patterns of somatic complaints were then analyzed by chi square test. Results: Out of 100 patients we placed 50 each in group I (anxiety) and group II (Depression). Males were higher in depression whereas females were higher in anxiety disorder group. P-value for headache was 0.017 while in rest of the somatic symptoms it was insignificant ranging from 0.4 to 1. Conclusion: We found that the patterns of somatic symptoms are present in both the groups of anxiety and depression like symptoms related to musculoskeletal and gastrointestinal system were commonly observed in cases of depression whereas symptoms related to autonomic nervous system and cardiovascular system is more significantly somatized in patients of anxiety. A larger sample is required for further studies to get better results. (author)

Characteristics associated with presence of depressive symptoms in adults with autism spectrum disorder.

Science.gov (United States)

Sterling, Lindsey; Dawson, Geraldine; Estes, Annette; Greenson, Jessica

2008-07-01

Evidence suggests that individuals with autism spectrum disorders (ASD) often exhibit associated psychiatric symptoms, particularly related to depression. The current study investigated whether individual characteristics, specifically, severity of ASD symptoms, level of cognitive ability, and/or presence of other psychiatric disorders, are associated with occurrence of depressive symptoms in adults with ASD. Forty-six adults with ASD were administered a standardized psychiatric history interview. Twenty participants (43%) endorsed depressive symptoms. It was found that individuals with less social impairment, higher cognitive ability, and higher rates of other psychiatric symptoms, were more likely to report depressive symptoms. These characteristics may be vulnerability factors for the development of depression, and should be considered when screening and treating adults with ASD.

Symptom burden in long-term germ cell tumor survivors.

Science.gov (United States)

Oechsle, Karin; Hartmann, Michael; Mehnert, Anja; Oing, Christoph; Bokemeyer, Carsten; Vehling, Sigrun

2016-05-01

Testicular germ cell tumor (GCT) and its treatment may cause distressing long-term symptoms. We aimed to examine self-reported symptom frequency and distress as well as the impact of demographic and medical characteristics in GCT survivors. A total of 164 GCT survivors receiving follow-up care at the University Cancer Center Hamburg and a specialized private practice facility were interviewed at a median time of 11.6 years after first diagnosis. Metastatic disease was present in 48 % of the patients and relapse had occurred in 17 %. The patients completed the short form of the Memorial Symptom Assessment Scale (MSAS-SF) assessing 28 physical and 4 psychological symptoms. The mean number of physical symptoms was 4.5 (SD = 4.3) (psychological symptoms M = 1.4, SD = 1.4; total M = 5.9, SD = 5.2). The most frequent physical symptoms were lack of energy (49 %), feeling drowsy (42 %), sleeping problems (36 %), and difficulty in concentration (32 %). Lack of energy was experienced as highly distressing by 21 % of the patients. The most frequent psychological symptoms were irritability (47 %) and being worried (42 %). The number of physical symptoms was associated with higher age, lower socioeconomic status, and shorter time since diagnosis in multivariate regression analyses controlling for metastatic vs. localized disease, relapse, extent of surgery, number of chemotherapy cycles, and radiotherapy. GCT survivors suffered from a significant number of long-term symptoms. Fatigue-related symptoms were most frequent and perceived as highly distressing. Continuous attention toward fatigue is necessary throughout follow-up care to offer support in time, particularly in more vulnerable patients of higher age and lower socioeconomic status.

A History of Learning Communities within American Higher Education

Science.gov (United States)

Fink, John E.; Inkelas, Karen Kurotsuchi

2015-01-01

This chapter describes the historical development of learning communities within American higher education. We examine the forces both internal and external to higher education that contributed to and stalled the emergence of learning communities in their contemporary form.

Prognostic value of bone involvement in patients with squamous cell carcinoma of the external and middle ear

Energy Technology Data Exchange (ETDEWEB)

Shiga, Hideaki; Ito, Makoto; Uramoto, Naoki; Hatano, Miyako; Miwa, Takaki; Furukawa, Mitsuru [Kanazawa Univ., Graduate School of Medical Science, Kanazawa, Ishikawa (Japan)

2007-05-15

The incidence of the external and middle ear squamous cell carcinoma (SCC) is extremely rare in the head and neck cancer with less than 1%. Therefore, the correlation between the staging classification and the prognosis has not been clear. Prognostic factors for patients with the external and middle ear SCC were assessed in the initial clinical symptoms and radiographic imaging. 13 patients with the external and middle ear SCC (5 male and 8 female) that had been treated at the Department of Otorhinolaryngology, Kanazawa University hospital from 2000 to 2006 were selected for this study. The radiation therapy followed surgery in ten patients. One patient received the radical cure irradiation before surgery. Two patients received a surgical excision alone. The temporal bone involvement and the parotid gland involvement in the radiographic image (computed tomography imaging and/or magnetic resonance imaging) were assessed. Clinical symptoms (otalgia, hearing disturbance, tinnitus, vertigo and facial nerve palsy) before treatment were reviewed based on the medical record. The correlation of those clinical factors and T staging in the Pittsburgh classification with overall survival was statistically assessed. The temporal bone involvement significantly correlated with worse prognosis. However, parotid gland involvement did not influence the prognosis. Moreover, statistically significant difference in T staging of the Pittsburgh classification (T1{center_dot}T2 vs. T3{center_dot}T4) was not found. The temporal bone involvement in the radiographic image was a prognostic factor for patients with the external and middle ear SCC. Pittsburgh classification needs to be modified because the bony part of the external auditory canal involvement is considered as T2 stage and the soft tissue involvement is defined as T4 stage. (author)

ExternE - valuation of hydro power in Klippen. Final report

International Nuclear Information System (INIS)

Nilsson, Maans

1998-08-01

'true' average willingness to pay for these respondents is within these boundaries. The average willingness to pay was 300-700 SEK/year for Swedes, 600-1900 SEK/year for Locals and 500-2000 SEK/year for Tourists. Total national benefits can be estimated from the average willingness to pay for the three categories. With a total production estimated at 5820 GWh, the externalities are estimated to 54-125 mEcu/kWh from the Swede sample, 0.12-0.33 mEcu/kWh for the locals sample and 1.7-7.7 mEcu/kWh for the tourist sample. The question whether decision-makers should use these CV-results as estimates of the damages induced by a specific project cannot be answered in simple way. There are a number of ethical/philosophical questions as well as methodological pitfalls that must be taken very seriously. It is a challenge to communicate adequate information to a lay audience on a complex phenomenon such as the river ecosystems and impacts of hydro power developments. There is a risk that respondents are ill-informed when they are asked to state a willingness to pay. The results from the Swede sample must be interpreted with serious caution as we see a risk of an embedding effect. We have higher confidence in the samples of Locals and Tourists, who are better informed and familiar with the issue 38 refs, 4 figs, 5 tabs, 1 appendix

Doing Gender Online: New Mothers’ Psychological Characteristics, Facebook Use, and Depressive Symptoms

Science.gov (United States)

Schoppe-Sullivan, Sarah J.; Yavorsky, Jill E.; Bartholomew, Mitchell K.; Sullivan, Jason M.; Lee, Meghan A.; Kamp Dush, Claire M.; Glassman, Michael

2016-01-01

Online social networking sites, such as Facebook, have provided a new platform for individuals to produce and reproduce gender through social interactions. New mothers, in particular, may use Facebook to practice behaviors that align with their mothering identity and meet broader societal expectations, or in other words, to “do motherhood.” Given that Facebook use may undermine well-being, it is important to understand the individual differences underlying new mothers’ experiences with Facebook during the stressful first months of parenthood. Using survey data from a sample of 127 new mothers with Facebook accounts residing in the U.S. Midwest, we addressed two key questions: (a) Are individual differences in new mothers’ psychological characteristics associated with their use and experiences of Facebook? and (b) Are new mothers’ psychological characteristics associated with greater risk for depressive symptoms via their use and experiences of Facebook? Regression analyses revealed that mothers who were more concerned with external validation of their identities as mothers and those who believed that society holds them to excessively high standards for parenting engaged in more frequent Facebook activity and also reported stronger emotional reactions to Facebook commentary. Moreover, mothers who were more concerned with external validation were more likely to have featured their child in their Facebook profile picture. Mediation analyses indicated that mothers who were more prone to seeking external validation for their mothering identity and perfectionistic about parenting experienced increases in depressive symptoms indirectly via greater Facebook activity. PMID:28239228

Doing Gender Online: New Mothers' Psychological Characteristics, Facebook Use, and Depressive Symptoms.

Science.gov (United States)

Schoppe-Sullivan, Sarah J; Yavorsky, Jill E; Bartholomew, Mitchell K; Sullivan, Jason M; Lee, Meghan A; Kamp Dush, Claire M; Glassman, Michael

2017-03-01

Online social networking sites, such as Facebook, have provided a new platform for individuals to produce and reproduce gender through social interactions. New mothers, in particular, may use Facebook to practice behaviors that align with their mothering identity and meet broader societal expectations, or in other words, to "do motherhood." Given that Facebook use may undermine well-being, it is important to understand the individual differences underlying new mothers' experiences with Facebook during the stressful first months of parenthood. Using survey data from a sample of 127 new mothers with Facebook accounts residing in the U.S. Midwest, we addressed two key questions: (a) Are individual differences in new mothers' psychological characteristics associated with their use and experiences of Facebook? and (b) Are new mothers' psychological characteristics associated with greater risk for depressive symptoms via their use and experiences of Facebook? Regression analyses revealed that mothers who were more concerned with external validation of their identities as mothers and those who believed that society holds them to excessively high standards for parenting engaged in more frequent Facebook activity and also reported stronger emotional reactions to Facebook commentary. Moreover, mothers who were more concerned with external validation were more likely to have featured their child in their Facebook profile picture. Mediation analyses indicated that mothers who were more prone to seeking external validation for their mothering identity and perfectionistic about parenting experienced increases in depressive symptoms indirectly via greater Facebook activity.

QUALITY ASSURANCE SYSTEMS IN POLISH AND UKRAINIAN HIGHER EDUCATION. A COMPARATIVE ANALYSIS

Directory of Open Access Journals (Sweden)

Marta Tutko

2015-02-01

Full Text Available The article deals with the progress made to develop external and internal quality assurance systems in Polish and Ukrainian higher education in the European Higher Education Area background. The focus of the paper is on the extent to which quality assurance systems in these countries are following the Standards and Guidelines for Quality Assurance in the European Higher Education Area. Furthermore, internal and external quality assur-ance in the European context is presented in the article. The authors of the article also conducted a comparative analysis of quality assurance systems in Polish and Ukrainian higher education.

Externalizing Behaviors and Callous-Unemotional Traits: Different Associations With Sleep Quality.

Science.gov (United States)

Denis, Dan; Akhtar, Reece; Holding, Benjamin C; Murray, Christina; Panatti, Jennifer; Claridge, Gordon; Sadeh, Avi; Barclay, Nicola L; O'Leary, Rachael; Maughan, Barbara; McAdams, Tom A; Rowe, Richard; Eley, Thalia C; Viding, Essi; Gregory, Alice M

2017-08-01

Sleep quality is associated with different aspects of psychopathology, but relatively little research has examined links between sleep quality and externalizing behaviors or callous-unemotional traits. We examined: (1) whether an association exists between sleep quality and externalizing behaviors; (2) whether anxiety mediates this association; (3) whether callous-unemotional traits are associated with sleep quality. Data from two studies were used. Study 1 involved 1556 participants of the G1219 study aged 18-27 years (62% female). Questionnaire measures assessed sleep quality, anxiety, externalizing behaviors, and callous-unemotional traits. Study 2 involved 338 participants aged 18-66 years (65% female). Questionnaires measured sleep quality, externalizing behaviors, and callous-unemotional traits. In order to assess objective sleep quality, actigraphic data were also recorded for a week from a subsample of study 2 participants (n = 43). In study 1, poorer sleep quality was associated with greater externalizing behaviors. This association was partially mediated by anxiety and moderated by levels of callous-unemotional traits. There was no significant relationship between sleep quality and callous-unemotional traits. In study 2, poorer sleep quality, as assessed via self-reported but not objective measures, was associated with higher levels of externalizing behaviors. Furthermore, in study 2, better sleep quality (indicated in both questionnaires and actigraphy measures: lower mean activity, and greater sleep efficiency) was associated with higher levels of callous-unemotional traits. Self-reports of poorer sleep quality are associated with externalizing behaviors, and this association is partially mediated by anxiety. Callous-unemotional traits are not associated with poor sleep and may even be related to better sleep quality. This is an exceptional finding given that poor sleep quality appears to be a characteristic of most psychopathology. © Sleep Research

Cancer of the external auditory canal

DEFF Research Database (Denmark)

Nyrop, Mette; Grøntved, Aksel

2002-01-01

OBJECTIVE: To evaluate the outcome of surgery for cancer of the external auditory canal and relate this to the Pittsburgh staging system used both on squamous cell carcinoma and non-squamous cell carcinoma. DESIGN: Retrospective case series of all patients who had surgery between 1979 and 2000....... Median follow-up was 47 months (range, 2-148 months). Data on age, sex, symptoms, TNM status, histopathological diagnosis, surgery, adjunctive therapy, sequelae, recurrence, and status at follow-up were obtained. SETTING: An ear, nose, and throat department in an ambulatory and hospitalized care center....... PATIENTS: Ten women and 10 men with previously untreated primary cancer. Median age at diagnosis was 67 years (range, 31-87 years). Survival data included 18 patients with at least 2 years of follow-up or recurrence. INTERVENTION: Local canal resection or partial temporal bone resection. MAIN OUTCOME...

Elements and Symptoms of an Ineffective Higher Education System: Evidence from a Greek University

Science.gov (United States)

Katsikas, Elias S.

2010-01-01

University studies in Greece are characterised by a symptom usually described as "prolonged student status". This refers to students who prolong the period of their studies beyond the expected length for degrees, sometimes by many years. This article, as well as recording the distribution of the duration of studies in a public…

Temperament and personal character relationship with symptoms of schizophrenia disorder

Directory of Open Access Journals (Sweden)

Abbas Abolghasemi

2011-09-01

Full Text Available Background: Knowledge is limited concerning the role of temperament and character factors on schizophrenia. Recent studies suggest that dimensions of temperament and character influence symptoms and functions in schizophrenia. The purpose of this study was to determine the relationship between temperament and character with positive and negative symptoms in patients with schizophrenia.Methods: The research sample consisted of 100 men which were randomly selected from schizophrenia patients with positive and negative symptoms at Razi hospital in Tabriz. Temperament and character inventory and positive and negative symptoms scale were used for data collection. Data was analyzed using t-test and discriminate analyses. Results: The research findings showed that patients with schizophrenia with negative symptoms had higher levels of self– transcendence and harm avoidance. However, patients with schizophrenia with positive symptoms had higher levels of cooperativeness. The results of discriminate analysis showed that explained 37 percent of variance of self– transcendence, harm avoidance and cooperativeness for only function between groups of schizophrenia with positive and negative symptoms. Discriminate function obtained was classified correctly by stepwise method 68.3 percent schizophrenia with positive and negative symptoms.Conclusion: It can be concluded that self– transcendence, harm avoidance and cooperativeness discriminated the patients with schizophrenia with positive and negative symptoms. The study confirmed important implications about intensity of symptomology and early intervention for patients with schizophrenia.

Predicting Internalizing and Externalizing Symptoms in Children with ASD: Evaluation of a Contextual Model of Parental Factors

Science.gov (United States)

McRae, Elizabeth M.; Stoppelbein, Laura; O'Kelley, Sarah E.; Fite, Paula; Greening, Leilani

2018-01-01

Parental adjustment, parenting behaviors, and child routines have been linked to internalizing and externalizing child behavior. The purpose of the present study was to evaluate a comprehensive model examining relations among these variables in children with ASD and their parents. Based on Sameroff's Transactional Model of Development (Sameroff…

Learned Helplessness and Depressive Symptoms Following Myocardial Infarction.

Science.gov (United States)

Smallheer, Benjamin A; Vollman, Michael; Dietrich, Mary S

2018-06-01

Psychosocial factors are known to impact depressive symptoms across clinical populations. Learned helplessness has the potential of affecting depressive symptoms following acute myocardial infarction (AMI), though little is known about this relationship. The purpose of this study was to examine the relationship between learned helplessness and depressive symptoms in patients following an AMI. Using a descriptive cross-sectional design, participants with a diagnosed AMI within the past 12 months were recruited. Standardized instruments and measures were used to evaluate learned helplessness and depressive symptoms. A statistically significant direct relationship was found between learned helplessness and depressive symptoms, suggesting that individuals with higher self-reported levels of learned helplessness also reported more depressive symptoms. These results indicate learned helplessness is associated with depressive symptoms in individuals following an AMI. In developing post-AMI treatment plans, health care staff should focus on psychologic points of intervention to the same extent as physiologic interventions.

Genetic and Environmental Influences on the Co-development between Borderline Personality Disorder Traits, Major Depression Symptoms, and Substance Use Disorder Symptoms from Adolescence to Young Adulthood

Science.gov (United States)

Bornovalova, Marina A.; Verhulst, Brad; Webber, Troy; McGue, Matt; Iacono, William G.; Hicks, Brian M.

2017-01-01

Although borderline personality disorder (BPD) traits decline from adolescence to adulthood, comorbid psychopathology such as symptoms of major depressive disorder (MDD), alcohol use disorder (AUD), and drug use disorders (DUDs) likely disrupt this normative decline. Using a longitudinal sample of female twins (N = 1,763), we examined if levels of BPD traits were correlated with changes in MDD, AUD, and DUD symptoms from ages 14–24. A parallel process biometric latent growth model examined the contributions of genetic and environmental factors to the relationships between developmental components of these phenotypes. Higher BPD trait-levels predicted a greater rate of increase in AUD and DUD symptoms, and higher AUD and DUD symptoms predicted a slower rate of decline of BPD traits from ages 14–24. Common genetic influences accounted for the associations between BPD traits and each disorder, as well as the interrelationships of AUD and DUD symptoms. Both genetic and nonshared environmental influences accounted for the correlated levels between BPD traits and MDD symptoms, but solely environmental influences accounted for the correlated changes between the two over time. Results indicate that higher levels of BPD traits may contribute to an earlier onset and faster escalation of AUD and DUD symptoms, and substance use problems slow the normative decline in BPD traits. Overall, our data suggests that primarily genetic influences contribute to the comorbidity between BPD features and substance use disorder symptoms. We discuss our data in the context of two major theories of developmental psychopathology and comorbidity. PMID:28420454

The ankle joint - value of different radiological examinations especially in external ligament injuries

International Nuclear Information System (INIS)

Dengel, H.

1984-01-01

For a correct radiological positioning of the ankle joint the bimalleolar line is helpful as well for the A.P.-view as for the lateral view. For the examination of external ligament lacerations Radiography with functional test is not always sufficient. After critical comparison of functional radiographs, clinical symptoms and case history arthrography is necessary in certain cases to come to a final conclusion. Indications for arthrography are stated and explained. (orig.) [de

Collapse of the balloon-expandable stent in the common iliac artery due to minor external compression in a lean patient

International Nuclear Information System (INIS)

Park, Sung Eun; Choi, Ho Cheol; Choi, Dae Seob; Lee, Sang Min; Lee, Jung Eun; Cho, Su Beom; Ahn, Jong Hwa

2017-01-01

A 60-year-old lean man with claudication due to severe stenosis of the right common iliac artery (CIA) underwent balloon-expandable stent deployment. Nineteen months later, claudication and lower limb ischemia in the patient recurred after minor external pressure and computed tomography indicated collapse of the right CIA stent. We performed balloon angioplasty again and self-expandable stent deployment was performed, and the patient's symptoms were relieved. We suggest that the CIA in a lean person could be susceptible to external pressure

Prospective randomized comparison of mitomycin C application in endoscopic and external dacryocystorhinostomy.

Science.gov (United States)

Mudhol, Rekha R; Zingade, N D; Mudhol, R S; Harugop, Anil S; Das, Amal T

2013-08-01

The aim of the study is to compare the subjective (relief of symptoms) and objective (endoscopic visualization of ostium patency at the time of syringing) outcomes at the end of two procedures-Endonasal DCR versus External DCR with Mitomycin C and to assess the role of Mitomycin C in maintaining patency of nasolacrimal drainage system. Prospective randomized comparative study was performed. Thirty-five patients were enrolled in each endoscopic and external dacryocystorhinostomy groups with Mitomycin C (MMC) application. The 37 eyes underwent endonasal DCR (28 unilateral primary eyes + 1 bilateral primary eyes + 5 unilateral revision eyes + 1 bilateral revision eye) while 35 eyes underwent external DCR (34 unilateral primary eyes + 1 unilateral revision eye). Mitomycin C 0.2 mg/ml was applied intra-operatively for 5 min to the ostium site at the end of endonasal or external DCR procedure. Objective assessment by syringing at the end of 1 year in the endonasal group showed 35 eyes (94%) were patent, 1 (3%) was partially blocked and 1(3%) was completely blocked; while in external group all 35 eyes (100%) were patent. Endoscopic visualization of the ostium at the time of syringing showed only one eye (3%) in the endonasal group was blocked while all the other eyes in both groups were patent. Both groups had a mean follow-up of 6-36 months. No complications were associated with use of Mitomycin C. In conclusion, intra-operative use of Mitomycin C in both endoscopic DCR and external DCR is safe and effective in increasing the success rate.

Hematoma Locations Predicting Delirium Symptoms After Intracerebral Hemorrhage.

Science.gov (United States)

Naidech, Andrew M; Polnaszek, Kelly L; Berman, Michael D; Voss, Joel L

2016-06-01

Delirium symptoms are associated with later worse functional outcomes and long-term cognitive impairments, but the neuroanatomical basis for delirium symptoms in patients with acute brain injury is currently uncertain. We tested the hypothesis that hematoma location is predictive of delirium symptoms in patients with intracerebral hemorrhage, a model disease where patients are typically not sedated or bacteremic. We prospectively identified 90 patients with intracerebral hemorrhage who underwent routine twice-daily screening for delirium symptoms with a validated examination. Voxel-based lesion-symptom mapping with acute computed tomography was used to identify hematoma locations associated with delirium symptoms (N = 89). Acute delirium symptoms were predicted by hematoma of right-hemisphere subcortical white matter (superior longitudinal fasciculus) and parahippocampal gyrus. Hematoma including these locations had an odds ratio for delirium of 13 (95 % CI 3.9-43.3, P delirium symptoms. Higher odds ratio for delirium was increased due to hematoma location. The location of neurological injury could be of high prognostic value for predicting delirium symptoms.

Unilateral solitary choroid metastasis from breast cancer: Rewarding results of external radiotherapy

Directory of Open Access Journals (Sweden)

Nirmala S

2008-01-01

Full Text Available Intraocular metastatic tumor is the commonest intraocular malignancy in adults, with uveal tract the commonest site. In nearly 85% of cases the choroid is the afflicted site due to its vascularity. Breast and lung are the common primaries. In breast primaries, this could be the first metastatic disease. This condition should always be kept in mind in patients with visual symptoms. Fundus examination, ultrasonography and CT/MRI of the orbit help in diagnosis. Early recognition and timely treatment can save the visual function thus imparting good quality of life to the patient. External beam radiotherapy is a good local form of treatment. Hormone therapy in hormone receptor positive tumors can have additional benefits. Here we report a case of unilateral solitary choroid metastasis in a case of breast cancer treated with external beam radiotherapy.

Are higher blood mercury levels associated with dry eye symptoms in adult Koreans? A population-based cross-sectional study.

Science.gov (United States)

Chung, So-Hyang; Myong, Jun-Pyo

2016-04-27

The purpose of this study was to investigate whether blood mercury concentrations associated with the presence of dry eye symptoms in a nationally representative Korean population. Population-based prospective cross-sectional study using the heavy metal data set of the 2010-2012 Korean National Health and Nutrition Examination Survey (KNHANES). A total of 4761 adult Koreans were the eligible population in this study. Of the 7162 survey participants, 2401 were excluded because they were eye surgery. Blood mercury levels were measured on the day the participants completed a questionnaire regarding the presence of dry eye symptoms (persistent dryness or eye irritation). The population was divided into low and high groups by median level (4.26 and 2.89 µg/L for males and females, respectively). Self-reported dry eye symptoms were present in 13.0% of the cohort. Participants with dry eye symptoms were significantly more likely to have blood mercury levels exceeding the median than those without dry eye symptoms (45.7% vs 51.7%, p=0.021). Logistic regression analysis showed that, after adjusting for age, gender, education, total household income, smoking status, heavy alcohol use, sleep time, perceived stress status, total cholesterol levels and atopy history, dry eye symptoms were significantly associated with blood mercury levels that exceeded the median (reference: lower mercury group; OR, 1.324; 95% CI 1.059 to 1.655; pdry eye symptoms in a nationally representative Korean population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Thoughts on Internal and External Quality Assurance

Science.gov (United States)

Zhang, Jianxin

2012-01-01

Quality assurance of higher education is made up of two parts: internal quality assurance (IQA) and external quality assurance (EQA). Both belong to a union of the coexistence and balance of yin and yang. But in reality there exists a paradox of "confusion of quality assurance (QA) subject consciousness, singularity of social QA and lack of QA…

Symptom recovery after thoracic surgery: Measuring patient-reported outcomes with the MD Anderson Symptom Inventory.

Science.gov (United States)

Fagundes, Christopher P; Shi, Qiuling; Vaporciyan, Ara A; Rice, David C; Popat, Keyuri U; Cleeland, Charles S; Wang, Xin Shelley

2015-09-01

Measuring patient-reported outcomes (PROs) has become increasingly important for assessing quality of care and guiding patient management. However, PROs have yet to be integrated with traditional clinical outcomes (such as length of hospital stay), to evaluate perioperative care. This study aimed to use longitudinal PRO assessments to define the postoperative symptom recovery trajectory in patients undergoing thoracic surgery for lung cancer. Newly diagnosed patients (N = 60) with stage I or II non-small cell lung cancer who underwent either standard open thoracotomy or video-assisted thoracoscopic surgery lobectomy reported multiple symptoms from before surgery to 3 months after surgery, using the MD Anderson Symptom Inventory. We conducted Kaplan-Meier analyses to determine when symptoms returned to presurgical levels and to mild-severity levels during recovery. The most-severe postoperative symptoms were fatigue, pain, shortness of breath, disturbed sleep, and drowsiness. The median time to return to mild symptom severity for these 5 symptoms was shorter than the time to return to baseline severity, with fatigue taking longer. Recovery from pain occurred more quickly for patients who underwent lobectomy versus thoracotomy (8 vs 18 days, respectively; P = .022). Patients who had poor preoperative performance status or comorbidities reported higher postoperative pain (all P < .05). Assessing symptoms from the patient's perspective throughout the postoperative recovery period is an effective strategy for evaluating perioperative care. This study demonstrates that the MD Anderson Symptom Inventory is a sensitive tool for detecting symptomatic recovery, with an expected relationship among surgery type, preoperative performance status, and comorbid conditions. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Clinical features of obsessive-compulsive disorder with hoarding symptoms: a multicenter study.

Science.gov (United States)

Torres, Albina R; Fontenelle, Leonardo F; Ferrão, Ygor A; do Rosário, Maria Conceição; Torresan, Ricardo C; Miguel, Eurípedes C; Shavitt, Roseli G

2012-06-01

Factor analyses indicate that hoarding symptoms constitute a distinctive dimension of obsessive-compulsive disorder (OCD), usually associated with higher severity and limited insight. The aim was to compare demographic and clinical features of OCD patients with and without hoarding symptoms. A cross sectional study was conducted with 1001 DSM-IV OCD patients from the Brazilian Research Consortium of Obsessive-Compulsive Spectrum Disorders (CTOC), using several instruments. The presence and severity of hoarding symptoms were determined using the Dimensional Yale-Brown Obsessive-Compulsive Scale. Statistical univariate analyses comparing factors possibly associated with hoarding symptoms were conducted, followed by logistic regression to adjust the results for possible confounders. Approximately half of the sample (52.7%, n = 528) presented hoarding symptoms, but only four patients presented solely the hoarding dimension. Hoarding was the least severe dimension in the total sample (mean score: 3.89). The most common lifetime hoarding symptom was the obsessive thought of needing to collect and keep things for the future (44.0%, n = 440). After logistic regression, the following variables remained independently associated with hoarding symptoms: being older, living alone, earlier age of symptoms onset, insidious onset of obsessions, higher anxiety scores, poorer insight and higher frequency of the symmetry-ordering symptom dimension. Concerning comorbidities, major depressive, posttraumatic stress and attention deficit/hyperactivity disorders, compulsive buying and tic disorders remained associated with the hoarding dimension. OCD hoarding patients are more likely to present certain clinical features, but further studies are needed to determine whether OCD patients with hoarding symptoms constitute an etiologically discrete subgroup. Copyright © 2012 Elsevier Ltd. All rights reserved.

The relationship between parental depressive symptoms and offspring psychopathology: evidence from a children-of-twins study and an adoption study.

Science.gov (United States)

McAdams, T A; Rijsdijk, F V; Neiderhiser, J M; Narusyte, J; Shaw, D S; Natsuaki, M N; Spotts, E L; Ganiban, J M; Reiss, David; Leve, L D; Lichtenstein, P; Eley, T C

2015-01-01

Parental depressive symptoms are associated with emotional and behavioural problems in offspring. However, genetically informative studies are needed to distinguish potential causal effects from genetic confounds, and longitudinal studies are required to distinguish parent-to-child effects from child-to-parent effects. We conducted cross-sectional analyses on a sample of Swedish twins and their adolescent offspring (n = 876 twin families), and longitudinal analyses on a US sample of children adopted at birth, their adoptive parents, and their birth mothers (n = 361 adoptive families). Depressive symptoms were measured in parents, and externalizing and internalizing problems measured in offspring. Structural equation models were fitted to the data. Results of model fitting suggest that associations between parental depressive symptoms and offspring internalizing and externalizing problems remain after accounting for genes shared between parent and child. Genetic transmission was not evident in the twin study but was evident in the adoption study. In the longitudinal adoption study child-to-parent effects were evident. We interpret the results as demonstrating that associations between parental depressive symptoms and offspring emotional and behavioural problems are not solely attributable to shared genes, and that bidirectional effects may be present in intergenerational associations.

Autonomy-connectedness and internalizing-externalizing personality psychopathology, among outpatients

NARCIS (Netherlands)

Bachrach, N.; Bekker, M.H.J.; Croon, M.A.

2013-01-01

Objectives The aims of this research were to investigate gender differences in levels of autonomy-connectedness, Axis I Psychopathology, and higher order factors of internalizing and externalizing personality psychopathology and, second, to investigate the association between these variables. Design

Children exposed to intimate partner violence: Identifying differential effects of family environment on children's trauma and psychopathology symptoms through regression mixture models.

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McDonald, Shelby Elaine; Shin, Sunny; Corona, Rosalie; Maternick, Anna; Graham-Bermann, Sandra A; Ascione, Frank R; Herbert Williams, James

2016-08-01

The majority of analytic approaches aimed at understanding the influence of environmental context on children's socioemotional adjustment assume comparable effects of contextual risk and protective factors for all children. Using self-reported data from 289 maternal caregiver-child dyads, we examined the degree to which there are differential effects of severity of intimate partner violence (IPV) exposure, yearly household income, and number of children in the family on posttraumatic stress symptoms (PTS) and psychopathology symptoms (i.e., internalizing and externalizing problems) among school-age children between the ages of 7-12 years. A regression mixture model identified three latent classes that were primarily distinguished by differential effects of IPV exposure severity on PTS and psychopathology symptoms: (1) asymptomatic with low sensitivity to environmental factors (66% of children), (2) maladjusted with moderate sensitivity (24%), and (3) highly maladjusted with high sensitivity (10%). Children with mothers who had higher levels of education were more likely to be in the maladjusted with moderate sensitivity group than the asymptomatic with low sensitivity group. Latino children were less likely to be in both maladjusted groups compared to the asymptomatic group. Overall, the findings suggest differential effects of family environmental factors on PTS and psychopathology symptoms among children exposed to IPV. Implications for research and practice are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Posttraumatic Stress, Family Functioning, and Externalizing in Adolescents Exposed to Violence: A Moderated Mediation Model.

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Deane, Kyle; Richards, Maryse; Mozley, Michaela; Scott, Darrick; Rice, Catherine; Garbarino, James

2016-09-02

Exposure to community violence disproportionately impacts low-income, minority youth and is associated with posttraumatic stress symptoms and maladaptive adjustment. This study investigates whether posttraumatic stress mediates the relation between exposure to community violence and externalizing symptoms and the moderating role of family cohesion and daily family support in buffering these effects on later externalizing. Low-income, African American 7th-grade students (M age = 12.57 years; N = 254) from high-crime neighborhoods participated in a 2-year longitudinal study measuring the effects of community violence exposure. The students completed questionnaires administered by research staff over 5 consecutive days for each year of the study. Family cohesion and daily family support exhibited a significant buffering effect for several outcomes. Posttraumatic stress significantly mediated the effect of witnessing community violence on subsequent aggression. The strength of these indirect effects depended on level of family cohesion. The findings provide evidence in support of interventions provided at both individual and family levels. Mental health providers working with this population should be aware of the intertwined nature of exposure to community violence, posttraumatic stress, and subsequent maladaptive outcomes.

[External periareolar incision for subdermal mastectomy in men with gynecomastia].

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Montiel-Jarquín, Alvaro; Reyes-Páramo, Pedro; Ramos-Alvarez, Gloria; López-Colombo, Aurelio; Tinajero-Esquivel, Magdalena; Ruiz-León, Betzabé

2007-01-01

Gynecomastia describes a benign increase of the mammary gland in men. When medical treatment fails, symptoms and psychological alterations persist. Subdermal mastectomy is the definitive treatment and can be achieved by different incisions, each with potential complications. We undertook this study to present clinical characteristics of 11 patients with gynecomastia and the results obtained with subdermal mastectomy by means of external periareolar incision. A descriptive cohort study in male patients with gynecomastia was carried out in a third-level medical care hospital. Patients were treated with subdermal mastectomy by means of external periareolar incision. There were 11 male patients with an average age of 19 years (range: 11-60 years), 3 patients (27.2%) with bilateral gynecomastia and 8 patients (72.7%) with unilateral gynecomastia. Average time of evolution was 22 months (range: 16-48 months), 9 patients (81.8%) reported pain, 11 patients (100%) reported psychological alterations with cutaneous alteration, 11 patients (100%) had normal secondary sexual characteristics, 1 patient (9%) had supernumerary nipple development, and 11 patients (100%) had well-defined lesions. According to Simon's classification: seven patients (63.6%) were classified as grade 1, three patients (27.2%) as grade 2 and one patient (9.09%) as grade 3. Each patient had a subdermal mastectomy with external periareolar incision, 11 patients (100%) had a histopathological report of gynecomastia; 1 patient (9.09%) displayed keloid healing and none displayed complications inherent to the surgical procedure. Mastectomy by means of external periareolar incision is useful in the treatment of gynecomastia.

Ten Years of External Quality Audit in Australia: Evaluating Its Effectiveness and Success

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Shah, Mahsood

2012-01-01

External quality audits are now being used in universities across the world to improve quality assurance, accountability for quality education and transparency of public funding of higher education. Some countries such as Australia, New Zealand, United Kingdom, Sweden and Denmark have had external quality audits for more than a decade but there…

Predicting asthma in preschool children with asthma-like symptoms : Validating and updating the PIAMA risk score

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Hafkamp-de Groen, Esther; Lingsma, Hester F.; Caudri, Daan; Levie, Deborah; Wijga, Alet; Koppelman, Gerard H.; Duijts, Liesbeth; Jaddoe, Vincent W. V.; Smit, Henriette A.; Kerkhof, Marjan; Moll, Henriette A.; Hofman, Albert; Steyerberg, Ewout W.; de Jongste, Johan C.; Raat, Hein

2013-01-01

Background: The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) risk score predicts the probability of having asthma at school age among preschool children with suggestive symptoms. Objective: We sought to externally validate the PIAMA risk score at different ages and in ethnic and

Network externalities in telecommunication industry: An analysis of Serbian market

Directory of Open Access Journals (Sweden)

Trifunović Dejan

2016-01-01

Full Text Available This paper deals with network competition and provides empirical analysis of market concentration, network and call externalities, access pricing, price discrimination and switching costs in Serbian mobile phone telecommunications market. It is shown that network externalities governed the expansion of this market until 2008. Upon entry of VIP incumbents didn't engage in predatory behaviour towards entrant aiming to benefit from locked- in users. The policy of mobile phone number portability reduced on-net prices and substantially increased consumer's surplus. In contrast to some previous research, this policy was pro-competitive in Serbia. We have also determined that users of the network with the largest market share benefit the most from call externalities. Finally, one network does not price discriminate between outgoing and incoming roaming calls, which implies that users of this network have higher level pecuniary externalities in roaming compared to users of price discriminating networks.

Externalizing problems, attention regulation, and household chaos: a longitudinal behavioral genetic study.

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Wang, Zhe; Deater-Deckard, Kirby; Petrill, Stephen A; Thompson, Lee A

2012-08-01

Previous research documented a robust link between difficulties in self-regulation and development of externalizing problems (i.e., aggression and delinquency). In this study, we examined the longitudinal additive and interactive genetic and environmental covariation underlying this well-established link using a twin design. The sample included 131 pairs of monozygotic twins and 173 pairs of same-sex dizygotic twins who participated in three waves of annual assessment. Mothers and fathers provided reports of externalizing problems. Teacher report and observer rating were used to assess twin's attention regulation. The etiology underlying the link between externalizing problems and attention regulation shifted from a common genetic mechanism to a common environmental mechanism in the transition across middle childhood. Household chaos moderated the genetic variance of and covariance between externalizing problems and attention regulation. The genetic influence on individual differences in both externalizing problems and attention regulation was stronger in more chaotic households. However, higher levels of household chaos attenuated the genetic link between externalizing problems and attention regulation.

Cancer-related symptoms predict psychological wellbeing among prostate cancer survivors: results from the PiCTure study.

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Sharp, Linda; O'Leary, Eamonn; Kinnear, Heather; Gavin, Anna; Drummond, Frances J

2016-03-01

Prostate cancer treatments are associated with a range of symptoms and physical side-effects. Cancer can also adversely impact on psychological wellbeing. Because many prostate cancer-related symptoms and side-effects are potentially modifiable, we investigated associations between symptoms and psychological wellbeing among prostate cancer survivors. Postal questionnaires were distributed to men diagnosed with prostate cancer 2-18 years previously identified through cancer registries. General and prostate cancer-specific symptoms were assessed using the EORTC QLQ-C30 and QLQ-PR25, with higher symptom scores indicating more/worse symptomatology. Psychological wellbeing was assessed by the DASS-21. Associations between symptoms and each outcome were investigated using multivariate logistic regression, controlling for socio-demographic and clinical factors. A total 3348 men participated (response rate = 54%). Seventeen percent (95%CI 15.2%-17.9%), 16% (95%CI 15.1%-17.8%) and 11% (95%CI 9.5%-11.8%) of survivors scored in the range for depression, anxiety and distress on the DASS scales, respectively. In multivariate models, risk of depression on the DASS scale was significantly higher in men with higher urinary and androgen deprivation therapy (ADT)-related symptoms, and higher scores for fatigue, insomnia and financial difficulties. Risk of anxiety on the DASS scale was higher in men with higher scores for urinary, bowel and ADT-related symptoms and fatigue, dyspnoea and financial difficulties. Risk of distress on the DASS scale was positively associated with urinary, bowel and ADT-related symptoms, fatigue, insomnia and financial difficulties. Cancer-related symptoms significantly predict psychological wellbeing among prostate cancer survivors. Greater use of interventions and medications and to alleviate symptoms might improve psychological wellbeing of prostate cancer survivors. Copyright © 2015 John Wiley & Sons, Ltd.

Self-determined to exercise? Leisure-time exercise behavior, exercise motivation, and exercise dependence in youth.

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Symons Downs, Danielle; Savage, Jennifer S; DiNallo, Jennifer M

2013-02-01

Scant research has examined the determinants of primary exercise dependence symptoms in youth. Study purposes were to examine sex differences across leisure-time exercise behavior, motivation, and primary exercise dependence symptoms in youth and the extent to which exercise behavior and motivation predicted exercise dependence within the Self-Determination Theory framework. Adolescents (N = 805; mean age = 15 years; 46% girls) completed measures of exercise behavior, motivation, and exercise dependence in health/PE classes. One-way ANOVA revealed boys scored higher than girls on leisure-time exercise behavior, exercise dependence symptoms, and most of the exercise motivation subscales. Hierarchical regression analyses indicated a) sex, exercise behavior, motivation, and their interaction terms explained 39% of the variance in primary exercise dependence; b) Integrated Regulation and Introjected Regulation were important determinants of exercise dependence; and c) sex moderated the contributions of External Regulation for predicting exercise dependence such that boys in the high and low external regulation groups had higher symptoms than girls in the high and low external regulation groups. These preliminary findings support the controlled dimensions of Integrated Regulation (boys, girls), Introjected Regulation (boys, girls), and External Regulation (boys only) are important determinants of primary exercise dependence symptoms.

Relative contributions of external forcing factors to circulation and hydrographic properties in a micro-tidal bay

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Yoon, Seokjin; Kasai, Akihide

2017-11-01

The dominant external forcing factors influencing estuarine circulation differ among coastal environments. A three-dimensional regional circulation model was developed to estimate external influence indices and relative contributions of external forcing factors such as external oceanic forcing, surface heat flux, wind stress, and river discharge to circulation and hydrographic properties in Tango Bay, Japan. Model results show that in Tango Bay, where the Tsushima Warm Current passes offshore of the bay, under conditions of strong seasonal winds and river discharge, the water temperature and salinity are strongly influenced by surface heat flux and river discharge in the surface layer, respectively, while in the middle and bottom layers both are mainly controlled by open boundary conditions. The estuarine circulation is comparably influenced by all external forcing factors, the strong current, surface heat flux, wind stress, and river discharge. However, the influence degree of each forcing factor varies with temporal variations in external forcing factors as: the influence of open boundary conditions is higher in spring and early summer when the stronger current passes offshore of the bay, that of surface heat flux reflects the absolute value of surface heat flux, that of wind stress is higher in late fall and winter due to strong seasonal winds, and that of river discharge is higher in early spring due to snow-melting and summer and early fall due to flood events.

Signs and symptoms of temporomandibular disorders in women and men.

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Ferreira, Claudia Lúcia Pimenta; Silva, Marco Antônio Moreira Rodrigues da; Felício, Cláudia Maria de

2016-01-01

Women are more likely to present temporomandibular disorders (TMD); however, studies comparing genders in Brazilian samples are rare. To analyze the proportion of men and women, as well as the association between gender and age, problem duration, and TMD symptoms in patients admitted to an university clinic for treatment. Interview and assessment data of protocols from 1,000 patients diagnosed with TMD were collected and analyzed and then divided into two groups, male (n = 177) and female (n = 823). The exploratory analysis was based on contingency tables and χ2 test was carried out. Subsequently, the logistic regression model was used and the odds ratios (OR) concerning the evaluated comparisons were calculated. Females were more prevalent in the sample, and mean ages and TMD duration were similar between the groups, with higher occurrence in young adults (19 to 40 years old). The OR values showed an association between the female gender and the signs/symptoms of pain in the temporomandibular joint, pain in the facial muscles, neck and shoulders, headache, fatigue in the muscles of mastication, otologic symptoms, and dysphonia. Women had two times higher chances of presenting these symptoms than men. In the sample of Brazilian patients with TMD, the number of women who presented a higher prevalence of painful symptoms was greater, followed by otologic symptoms and complaints of dysphonia. The prevalence of joint noise was similar in both studied groups.

Amygdala-frontal connectivity predicts internalizing symptom recovery among inpatient adolescents.

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Venta, Amanda; Sharp, Carla; Patriquin, Michelle; Salas, Ramiro; Newlin, Elizabeth; Curtis, Kaylah; Baldwin, Philip; Fowler, Christopher; Frueh, B Christopher

2018-01-01

The possibility of using biological measures to predict the trajectory of symptoms among adolescent psychiatric inpatients has important implications. This study aimed to examine emotion regulation ability (measured via self-report) and a hypothesized proxy in resting-state functional connectivity [RSFC] between the amygdala and frontal brain regions as baseline predictors of internalizing symptom recovery during inpatient care. 196 adolescents (61% female; Mage = 15.20; SD = 1.48) completed the Achenbach Brief Problem Monitor (BPM) each week during their inpatient care. RSFC (n = 45) and self-report data of emotion regulation (n = 196) were collected at baseline. The average internalizing symptom score at admission was high (α 0 = 66.52), exceeding the BPM's clinical cut off score of 65. On average, internalizing symptom scores declined significantly, by 0.40 points per week (p = 0.004). While self-reported emotion regulation was associated with admission levels of internalizing problems, it did not predict change in symptoms. RSFC between left amygdala and left superior frontal gyrus was significantly associated with the intercept-higher connectivity was associated with higher internalizing at admission-and the slope- higher connectivity was associated with a more positive slope (i.e., less decline in symptoms). RSFC between the right amygdala and the left superior frontal gyrus was significantly, positively correlated with the slope parameter. Results indicate the potential of biologically-based measures that can be developed further for personalized care in adolescent psychiatry. Copyright © 2017 Elsevier B.V. All rights reserved.

Self-concept clarity across adolescence: longitudinal associations with open communication with parents and internalizing symptoms.

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Van Dijk, Marloes P A; Branje, Susan; Keijsers, Loes; Hawk, Skyler T; Hale, William W; Meeus, Wim

2014-11-01

Higher self-concept clarity is related to several adjustment indices and may be promoted by open communication with parents, while problems with self-concept clarity development could enhance internalizing problems (i.e., depressive and anxiety symptoms) in adolescence. This longitudinal study examined linkages between self-concept clarity, adolescents' open communication with parents, and adolescent depressive and anxiety symptoms. Dutch youths (N = 323; 51.1 % girls; mean age Time 1 = 13.3 years) reported on these constructs over four consecutive annual measurements. Concurrent positive links between open communication and self-concept clarity were found at Time 1. Over time, higher levels of open communication with parents predicted higher self-concept clarity only in middle adolescence (mean age between 14 and 15 years). We also found concurrent associations between self-concept clarity and both depressive and anxiety symptoms. Longitudinally, lower self-concept clarity predicted relatively higher levels of depressive symptoms across all waves, and also higher anxiety levels from Time 1 to Time 2. Conversely, higher levels of anxiety also predicted lower levels of self-concept clarity during the first three waves. Self-concept clarity did not mediate the longitudinal associations between open communication and internalizing symptoms. This study is one of the first to investigate self-concept clarity across adolescence. It highlights the possible importance of both anxiety symptoms and communication with parents in understanding the development of a clear self-concept, and demonstrates an association between lower self-concept clarity and higher levels of later depressive and anxiety symptoms.

Parenting intervention effects on parental depressive symptoms: examining the role of parenting and child behavior.

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Wong, Jessie J; Gonzales, Nancy A; Montaño, Zorash; Dumka, Larry; Millsap, Roger E

2014-06-01

Parental depression is a major risk factor in child development. Growing research suggests parenting programs can positively impact parental depressive symptoms, although the specific mechanisms that explain these effects are unknown. The current study examined parenting mediated effects of a parenting program on mothers' and fathers' depressive symptoms, as well as the role of child behavior in linking parenting to reductions in depressive symptoms. The study samples included 494 mothers and 288 fathers of Mexican origin adolescents who participated in a randomized trial of the Bridges to High School Program/Proyecto Puentes a la Secundaria, a universal prevention and promotion intervention that included parent training but did not directly target parental depressive symptoms. Parenting mediator models tested program effects on parental depressive symptoms through changes in harsh and supportive parenting. Results showed a significant indirect intervention effect on maternal depressive symptoms through changes in mothers' harsh parenting. Next, child behavior models revealed a partial mediation effect of harsh parenting and a full mediation effect of supportive parenting on maternal depressive symptoms through mothers' reports of child externalizing symptoms. Indirect effects of fathers' harsh and supportive parenting on paternal depressive symptoms were also found through fathers' reports of child behavior. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Impact of obsessive-compulsive personality disorder symptoms in Internet users.

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Chamberlain, Samuel R; Redden, Sarah A; Stein, Dan J; Lochner, Christine; Grant, Jon E

2017-08-01

Internet use is pervasive in many cultures. Little is known about the impact of obsessive-compulsive personality disorder (OCPD) symptoms on impulsive and compulsive psychopathologies in people who use the Internet. Adult Internet users (N = 1,323) completed an online questionnaire quantifying OCPD symptoms, likely occurrence of select mental disorders (obsessive-compulsive disorder, attention-deficit/hyperactivity disorder [ADHD], problematic Internet use, generalized anxiety disorder), and personality questionnaires of impulsivity and compulsivity. Predictors of the presence of OCPD symptoms (endorsement of at least 4 of 8 DSM-5 criteria) were identified using binary logistic regression. In regression (P OCPD symptoms were significantly associated with (in order of decreasing effect size) lower non-planning impulsivity, higher ADHD symptoms, problematic Internet use, avoidant personality disorder, female sex, generalized anxiety disorder, and some types of compulsions (checking, dressing/washing). These data suggest that OCPD symptoms, defined in terms of at least 4 of 8 DSM criteria being met, are common in Internet users. OCPD symptoms were associated with considerably higher levels of psychopathology relating to both impulsive (ADHD) and compulsive (OCD-related and problematic Internet use) disorders. These data merit replication and extension using standard in-person clinical assessments, because the current study relied on self-report over the Internet.

Collapse of the balloon-expandable stent in the common iliac artery due to minor external compression in a lean patient

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Park, Sung Eun; Choi, Ho Cheol; Choi, Dae Seob; Lee, Sang Min; Lee, Jung Eun [Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju (Korea, Republic of); Cho, Su Beom; Ahn, Jong Hwa [Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon (Korea, Republic of)

2017-08-15

A 60-year-old lean man with claudication due to severe stenosis of the right common iliac artery (CIA) underwent balloon-expandable stent deployment. Nineteen months later, claudication and lower limb ischemia in the patient recurred after minor external pressure and computed tomography indicated collapse of the right CIA stent. We performed balloon angioplasty again and self-expandable stent deployment was performed, and the patient's symptoms were relieved. We suggest that the CIA in a lean person could be susceptible to external pressure.

Characterization of hospitalizations due to external causes in the public health system, Brazil, 2011.

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Mascarenhas, Márcio Dênis Medeiros; Barros, Marilisa Berti de Azevedo

2015-01-01

The aim of this work is to describe the characteristics of hospital admissions owing to external causes in the public health system in Brazil in 2011. Data from the Hospital Information System of the Unified Health System (SIH/SUS) were analyzed to obtain the frequency, coefficient of hospitalization, and hospital morbidity indicators. Of the 973,015 admissions, falls (38.4%) predominated, followed by traffic accidents (15.8%). The estimated coefficient of hospitalization owing to external causes increased with the age, and it was higher in male patients and in the midwest region of the country. The average stay was higher in hospitalizations for traffic accidents (6.1 days) and assaults (6.0 days), while the hospital mortality rate reached higher values in hospitalizations for assaults (4.7%) and self-harms (4.0%). It is evident from the knowledge of the characteristics described the usefulness of hospital morbidity data for planning care actions and prevention of the external causes.

Use of American urological association symptom index of measuring urinary symptoms in radiotherapy as a quality of life instrument

International Nuclear Information System (INIS)

Lee, Misa M.; Mamo, Carol; Vijayakumar, Srinivasan

1997-01-01

PURPOSE/INTRODUCTION: In newly diagnosed prostate cancer patients, urinary symptoms due to a comorbid diagnosis of BPH is a common presentation. Furthermore, following radiotherapy patients often experience further urinary symptoms. However, it is not clear how much of these urinary symptoms impairing the quality of life are due to the radiotherapy versus the BPH. To objectively measure the influence of urinary symptoms on quality of life in BPH, the American Urological Association (AUA) has developed an evaluative instrument, AUA Symptom Index(AUASI). This self-administered questionnaire eliminates potential problems of interviewer bias and allows one to measure change in symptom levels over the time as well as with therapy. Its reliability and validity, including internal and external consistency and test-retest reliability have been well-documented. Because of its simplicity, concise-nature, already documented validity, and self-administered design, a survey using AUASI questionnaire was conducted pre- and post-radiotherapy for the following purposes: (1) to measure the difference in urinary symptoms after radiotherapy, thus identifying the treatment induced symptom profile; (2) to assess the feasibility of utilizing AUASI as a rational post-therapy toxicity measurement. MATERIALS and METHODS: A total of 18 patients with newly diagnosed prostate cancer were questioned regarding their urinary symptoms using AUASI. The AUASI which consists of 7 questions about irritative and obstructive symptoms was provided prospectively prior to the start of radiotherapy. Each patient indicated the presence of their symptoms on a scale rating from 0(not at all) to 5(almost always). The scores on the individual questions were then summed to give total index(range:0-35). Out of 18, 8 patients who completed a definitive radiotherapy were identified and surveyed with the same questionnaire to compare the pre- and post-therapy related urinary symptoms. RESULTS: There was no

Autism spectrum disorder symptoms in juvenile suspects of sex offenses.

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't Hart-Kerkhoffs, Lisette A; Jansen, Lucres M; Doreleijers, Theo A; Vermeiren, Robert; Minderaa, Ruud B; Hartman, Catharina A

2009-02-01

To investigate autism spectrum disorder (ASD) symptoms in juvenile suspects of sex offenses. A group of 175 juvenile suspected sex offenders (all males, mean +/- SD age = 14.9 +/- 1.4 years) was compared with a matched healthy control group (N = 500, mean +/- SD age = 14.0 +/- 1.4 years) and a group of children with DSM-IV-diagnosed ASD (N = 114, mean +/- SD age = 14.2 +/- 1.9 years) with respect to autistic symptoms as measured by means of a standardized questionnaire, the Children's Social Behavior Questionnaire. Furthermore, specific subgroups of sexual offenders, i.e., child molesters, solo peer offenders, and group offenders, were compared with regard to levels of ASD symptoms. The study was conducted from May 2003 to December 2006. Significantly higher levels of ASD symptoms were found in juvenile sex offenders than in healthy controls, while levels were lower than in the ASD group (F = 148.259, p symptoms than group offenders (F = 5.127, p symptoms are higher in juvenile suspects of sex offenses as compared to the healthy population, which argues for considering specific diagnostic assessment in this population, especially in solo offenders and child molesters. Copyright 2009 Physicians Postgraduate Press, Inc.

What Behavioral and Psychological Symptoms of Dementia Affect Caregiver Burnout?

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Hiyoshi-Taniguchi, Kazuko; Becker, Carl B; Kinoshita, Ayae

2018-01-01

Patients' irritability and aggression have been linked to caregiver depression, but the behaviors that most burden caregivers are not yet definitively identified. This study examines the connection between behavioral and psychological symptoms of dementia (BPSD) and the burnout of caregivers caring for home-dwelling elders with dementia symptoms in Japan. 80 Japanese rural and urban family caregivers completed detailed questionnaires about their experiences in caring for demented family members. We statistically analyzed the results for correlations between types of dementia, Pines Burnout, and Caregiver Distress. BPSD symptom severity significantly correlated with caregiver distress. The dementia symptoms most strongly correlated with caregiver burnout were: aggression, irritability, abnormal motor behavior, and hallucinations. Among the commonest symptoms, apathy, anxiety, and depression did not seriously aggravate caregiver burnout. Caregivers displayed higher burnout facing agitation/aggression, irritability, aberrant motor behavior, and hallucinations. Caregivers' reported distress was surprisingly dissimilar to their burnout scores; patients' delusions and anxiety led to higher distress reporting but not to burnout. Advance diagnosis of BPSD symptoms should be helpful to support nurses and caregivers of dementia patients. Particular support should be considered for caregivers and nurses of patients expressing aggression, irritability, abnormal motor behavior, and hallucination.

Rectal necrosis following external radiation therapy for carcinoma of the prostate: report of a case

International Nuclear Information System (INIS)

Quan, S.H.Q.; O'Kelly, P.J.

1975-01-01

Increasing attention is being paid to the use of radiation therapy in the management of primary carcinoma of the prostate. Since 1965, radical radiation therapy has been used at Memorial Hospital to treat primary carcinoma of the prostate. Small primary tumors are treated by implantation with radioactive iodine ( 125 I) seeds and larger tumors considered unsuitable for implantation are treated by external supervoltage beam therapy. Fifty patients had been treated by implantation and 30 by external beam therapy at the time of this report. None of the patients treated by implantation developed rectal symptoms. Proctitis developed in all patients treated by external radiation therapy and in half the patients chronic proctitis ensued, accompanied by the passage of mucus. The constant leaking of mucus through the anal sphincter produces irritation of the skin and intermittent attacks of pruritus ani, a discomfiting sequel. Apart from the proctitis, most patients tolerated treatment well, with one notable exception, in whom rectal necrosis developed. This case is described

Assessing the role of attention-deficit/hyperactivity disorder symptoms in smokers with and without posttraumatic stress disorder.

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Mitchell, John T; Van Voorhees, Elizabeth E; Dennis, Michelle F; McClernon, F Joseph; Calhoun, Patrick S; Kollins, Scott H; Beckham, Jean C

2012-08-01

Smoking prevalence among individuals with posttraumatic stress disorder (PTSD) is elevated relative to non-PTSD smokers, and there is evidence to suggest that affect regulation may be a motivation for smoking among those with this disorder. Previous studies have also indicated that (a) PTSD is frequently comorbid with attention-deficit/hyperactivity disorder (ADHD), (b) individuals with ADHD smoke at significantly higher rates than the general population, (c) subclinical ADHD symptoms are a risk factor for smoking, and (d) affect regulation is a motivation for smoking in ADHD. The goal of this study was to assess the degree to which ADHD symptoms were uniquely associated with smoking-related affective functioning (SRAF) variables above and beyond the variance already explained by PTSD symptoms. Smokers with (n = 55) and without PTSD (n = 68) completed measures assessing PTSD symptoms, ADHD symptoms, and SRAF. The PTSD group endorsed significantly more severe levels of DSM-IV inattentive and hyperactive-impulsive ADHD symptoms. A series of hierarchical regressions among the entire sample indicated that, after accounting for PTSD symptoms, ADHD symptoms were associated with lower positive affect, higher negative affect, higher emotion dysregulation, higher anxiety sensitivity, and higher urges to smoke to increase positive affect. Taken together, these findings suggest that ADHD symptoms may increase affective dysregulation difficulties already faced by smokers, particularly those with PTSD, which may, in turn, confer increased risk for smoking relapse in those with higher levels of symptomatology of both disorders.

Family Conflict, Mood, and Adolescents' Daily School Problems: Moderating Roles of Internalizing and Externalizing Symptoms

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Timmons, Adela C.; Margolin, Gayla

2015-01-01

Using daily diary data, this study examined cross-day associations between family conflict and school problems and tested mediating effects of daily negative mood and moderating effects of psychological symptoms. For 2 weeks, parents and adolescents (N = 106; M[subscript age] = 15.4) reported daily conflict; adolescents reported daily negative…

Deficits in agency in schizophrenia, and additional deficits in body image, body schema and internal timing, in passivity symptoms.

Directory of Open Access Journals (Sweden)

Kyran Trent Graham

2014-09-01

Full Text Available Individuals with schizophrenia, particularly those with passivity symptoms, may not feel in control of their actions, believing them to be controlled by external agents. Cognitive operations that contribute to these symptoms may include abnormal processing in agency, as well as body representations that deal with body schema and body image. However, these operations in schizophrenia are not fully understood, and the questions of general versus specific deficits in individuals with different symptom profiles remain unanswered. Using the projected hand illusion (a digital video version of the rubber hand illusion with syn-chronous and asynchronous stroking (500 ms delay, and a hand laterality judgment task, we assessed sense of agency, body image and body schema in 53 people with clinically stable schizophrenia (with a current, past, and no history of passivity symptoms and 48 healthy controls. The results revealed a stable trait in schizophrenia with no difference be-tween clinical subgroups (sense of agency, and some quantitative (specific differences de-pending on the passivity symptom profile (body image and body schema. Specifically, a reduced sense of self-agency was a common feature of all clinical subgroups. However, subgroup comparisons showed that individuals with passivity symptoms (both current and past had significantly greater deficits on tasks assessing body image and body schema, relative to the other groups. In addition, patients with current passivity symptoms failed to demonstrate the normal reduction in body illusion typically seen with a 500 ms delay in visual feedback (asynchronous condition, suggesting internal timing problems. Altogether, the results underscore self-abnormalities in schizophrenia, provide evidence for both trait abnormalities and state changes specific to passivity symptoms, and point to a role for internal timing deficits as a mechanistic explanation for external cues becoming a possible source of self

The Relationship between Musculoskeletal Symptoms and Work-related Risk Factors in Hotel Workers.

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Lee, Jin Woo; Lee, Ju Jong; Mun, Hyeon Je; Lee, Kyung-Jae; Kim, Joo Ja

2013-10-11

To identify work-related musculoskeletal symptoms and any associated work-related risk factors, focusing on structural labor factors among hotel workers. A total of 1,016 hotel workers (620 men and 396 women) were analyzed. The questionnaire surveyed participants' socio-demographics, health-related behaviors, job-related factors, and work-related musculoskeletal symptoms. Work-related musculoskeletal symptoms were assessed using the Nordic musculoskeletal questionnaire. All analyses were stratified by gender, and multiple logistic regression modeling was used to determine associations between work-related musculoskeletal symptoms and work-related risk factors. The risk of developing work-related musculoskeletal symptoms was 1.9 times higher among male workers in the kitchen department than males in the room department (OR = 1.92, 95% CI = 1.03-3.79), and 2.5 times higher among male workers with lower sleep satisfaction than those with higher sleep satisfaction (OR = 2.52, 95% CI = 1.57-4.04). All of the aforementioned cases demonstrated a statistically significant association with work-related musculoskeletal symptoms. Moreover, the risk of developing work-related musculoskeletal symptoms was 3.3 times higher among female workers aged between 30 and 34 than those aged 24 or younger (OR = 3.32, 95% CI = 1.56-7.04); 0.3 times higher among females in the back office department than those in the room department (OR = 0.34, 95% CI = 0.12-0.91); 1.6 times higher among females on shift schedules than those who were not (OR = 1.60, 95% CI = 1.02-2.59); 1.8 times higher among females who performed more intensive work than those who performed less intensive work (OR = 1.88, 95% CI = 1.17-3.02), and; 2.1 times higher among females with lower sleep satisfaction than those with higher sleep satisfaction (OR = 2.17, 95% CI = 1.34-3.50). All of the aforementioned cases also displayed a statistically significant association with work-related musculoskeletal symptoms. This study

Quality of the relationship and menopausal symptoms of menopausal women

Directory of Open Access Journals (Sweden)

Karolina Jarecka

2016-10-01

Full Text Available Background The aim of this study was to evaluate the occurrence and intensity of menopausal symptoms, taking into account the length of one’s relationship, its nature and one’s assessment of it. Participants and procedure The study included 200 women between the ages of 45 and 68, with secondary or higher education, married or in cohabiting relationships. Women were divided into three groups depending on the experience related to menopause: premenopause (46 respondents, perimenopause (75 respondents, and postmenopause (79 respondents. The study used a survey of self-design, the “Women’s Health” Questionnaire (WHQ by M. Hunter, and the “Partner Relations Questionnaire” (PFB by K. Hahlweg. Results Most menopausal symptoms – including those of the greatest severity – are experienced by women in perimenopausal and postmenopausal phases, but one’s own relationship’s assessment is the lowest in postmenopausal women. In this group of women, relevant and significant relations between the dimensions of the quality of the relationship and the menopausal symptoms are the most numerous. The most essential assessment was the one relating to intimacy – its poor evaluation is accompanied by higher intensity of experienced depression symptoms, somatic symptoms, and disorders of memory and concentration, sex and sleep, and also the sum of menopausal symptoms is higher. In all three groups, no significant differences in the severity of menopausal symptoms were observed between women in marital and cohabiting relationships. In women in the perimenopausal phase, the shorter the length of the relationship (its seniority, the greater is the severity of sexual dysfunction symptoms, whereas in women in the postmenopausal stage, along with the length of the relationship, the severity of psychological and somatic symptoms increases. Conclusions One should find that the perimenopausal and postmenopausal phases are particularly difficult for women

Relationship between cognitive and non-cognitive symptoms of delirium.

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Rajlakshmi, Aarya Krishnan; Mattoo, Surendra Kumar; Grover, Sandeep

2013-04-01

To study relationship between the cognitive and the non-cognitive symptoms of delirium. Eighty-four patients referred to psychiatry liaison services and met DSM-IVTR criteria of delirium were assessed using the Delirium Rating Scale Revised-1998 (DRSR-98) and Cognitive Test for Delirium (CTD). The mean DRS-R-98 severity score was 17.19 and DRS-R-98 total score was 23.36. The mean total score on CTD was 11.75. The mean scores on CTD were highest for comprehension (3.47) and lowest for vigilance (1.71). Poor attention was associated with significantly higher motor retardation and higher DRS-R-98 severity scores minus the attention scores. There were no significant differences between those with and without poor attention. Higher attention deficits were associated with higher dysfunction on all other domains of cognition on CTD. There was significant correlation between cognitive functions as assessed on CTD and total DRS-R-98 score, DRS-R-98 severity score and DRS-R-98 severity score without the attention item score. However, few correlations emerged between CTD domains and CTD total scores with cognitive symptom total score of DRS-R-98 (items 9-13) and non-cognitive symptom total score of DRS-R-98 (items 1-8). Our study suggests that in delirium, cognitive deficits are quite prevalent and correlate with overall severity of delirium. Attention deficit is a core symptom of delirium. Copyright © 2012 Elsevier B.V. All rights reserved.

A cognitive-perceptual model of symptom perception in males and females: the roles of negative affect, selective attention, health anxiety and psychological job demands.

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Goodwin, Laura; Fairclough, Stephen H; Poole, Helen M

2013-06-01

Kolk et al.'s model of symptom perception underlines the effects of trait negative affect, selective attention and external stressors. The current study tested this model in 263 males and 498 females from an occupational sample. Trait negative affect was associated with symptom reporting in females only, and selective attention and psychological job demands were associated with symptom reporting in both genders. Health anxiety was associated with symptom reporting in males only. Future studies might consider the inclusion of selective attention, which was more strongly associated with symptom reporting than negative affect. Psychological job demands appear to influence symptom reporting in both males and females.

Myxedema megacolon after external neck irradiation

International Nuclear Information System (INIS)

Borrie, M.J.; Cape, R.D.; Troster, M.M.; Fung, S.T.

1983-01-01

Myxedema megacolon is a rare manifestation of hypothyroidism. It may respond to appropriate treatment but is sometimes irreversible, resulting in fatal complications. Two possible mechanisms to explain the colonic atony include (1) myxomatous infiltration of the submucosa with separation of the muscular fibers from the ganglia of Auerbach's plexus, and (2) severe autonomic neuropathy affecting the extrinsic nerves to the colon and the myenteric plexus. Histology from our case supports the first proposed mechanism. Urecholine challenge and manometric measure response may help predict reversibility of colonic atony. Treatment should be individualized and should include factors such as age, duration of symptoms, and other medical illness. Low-dose oral or intravenous triiodothyronine is effective. Hypothyroidism following external radiation of the neck for lymphoma is not uncommon, and the risk increases following one or more lymphangiograms. Such patients should be followed up with regular TSH estimations for at least three years

Distinguishing types of social withdrawal in children: Internalizing and externalizing outcomes of conflicted shyness versus social disinterest across childhood.

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Kopala-Sibley, Daniel C; Klein, Daniel N

2017-04-01

Little research has examined the effect of subtypes of social withdrawal on the development of psychopathology across childhood. Parents of 493 children (220 females) completed a measure of their child's conflicted shyness and social disinterest as well as the Child Behaviour Checklist (CBCL) when their child was age 3, and again at age 6. When children were age 9, parents completed the CBCL. From 3 to 6, conflicted shyness predicted increases in anxiety symptoms in boys and girls, and predicted depressive symptoms in boys. From 6 to 9, social disinterest predicted increases in anxiety symptoms in girls and boys, and predicted increases in depressive symptoms in boys. In addition, in boys, conflicted shyness at age 6 predicted increases in externalizing symptoms at age 9. Conflicted shyness appears to be particularly problematic in early to middle childhood, while social disinterest appears to be more maladaptive in later childhood, with some differences by gender.

Pre- and Post-Natal Maternal Depressive Symptoms in Relation with Infant Frontal Function, Connectivity, and Behaviors

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Soe, Ni Ni; Wen, Daniel J.; Poh, Joann S.; Li, Yue; Broekman, Birit F. P.; Chen, Helen; Chong, Yap Seng; Kwek, Kenneth; Saw, Seang-Mei; Gluckman, Peter D.; Meaney, Michael J.; Rifkin-Graboi, Anne; Qiu, Anqi

2016-01-01

This study investigated the relationships between pre- and early post-natal maternal depression and their changes with frontal electroencephalogram (EEG) activity and functional connectivity in 6- and 18-month olds, as well as externalizing and internalizing behaviors in 24-month olds (n = 258). Neither prenatal nor postnatal maternal depressive symptoms independently predicted neither the frontal EEG activity nor functional connectivity in 6- and 18-month infants. However, increasing maternal depressive symptoms from the prenatal to postnatal period predicted greater right frontal activity and relative right frontal asymmetry amongst 6-month infants but these finding were not observed amongst 18-month infants after adjusted for post-conceptual age on the EEG visit day. Subsequently increasing maternal depressive symptoms from the prenatal to postnatal period predicted lower right frontal connectivity within 18-month infants but not among 6-month infants after controlling for post-conceptual age on the EEG visit day. These findings were observed in the full sample and the female sample but not in the male sample. Moreover, both prenatal and early postnatal maternal depressive symptoms independently predicted children’s externalizing and internalizing behaviors at 24 months of age. This suggests that the altered frontal functional connectivity in infants born to mothers whose depressive symptomatology increases in the early postnatal period compared to that during pregnancy may reflect a neural basis for the familial transmission of phenotypes associated with mood disorders, particularly in girls. PMID:27073881

Correlation between vocal tract symptoms and modern singing handicap index in church gospel singers.

Science.gov (United States)

Pinheiro, Joel; Silverio, Kelly Cristina Alves; Siqueira, Larissa Thaís Donalonso; Ramos, Janine Santos; Brasolotto, Alcione Ghedini; Zambon, Fabiana; Behlau, Mara

2017-08-24

To verify the correlation between vocal tract discomfort symptoms and perceived voice handicaps in gospel singers, analyzing possible differences according to gender. 100 gospel singers volunteered, 50 male and 50 female. All participants answered two questionnaires: Vocal Tract Discomfort (VTD) scale and the Modern Singing Handicap Index (MSHI) that investigates the vocal handicap perceived by singers, linking the results of both instruments (psinging. Female gospel singers present higher frequency and intensity of vocal tract discomfort symptoms, as well as higher voice handicap for singing than male gospel singers. The higher the frequency and intensity of the laryngeal symptoms, the higher the vocal handicap will be.

Heterogeneity in Clinical Symptoms and Cognitive Functioning of Children with Hyperactivity-Impulsivity and Inattention: Dimensional and Person-Centered Perspectives

Directory of Open Access Journals (Sweden)

Gambin Małgorzata J.

2016-06-01

Full Text Available The goal of this study was to investigate heterogeneity in clinical symptoms and cognitive functioning among children with hyperactivity-impulsivity and inattention using a novel approach that combined dimensional and person-centered perspectives. Executive, verbal and visuo-spatial functioning, hyperactivity-impulsivity, inattention, externalizing and internalizing symptoms were examined in 102 children (37 girls and 65 boys at risk for ADHD and 62 children (31 girls and 31 boys not at risk for ADHD in the age range of 8–10 years. We extracted seven groups with various profiles of psychopathological symptoms and cognitive functioning. We propose that symptoms of inattention and hyperactivity-impulsivity in these groups are related to different cognitive and affective-motivational problems.

Appetite and Weight Loss Symptoms in Late-Life Depression Predict Dementia Outcomes.

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Saha, Sayoni; Hatch, Daniel J; Hayden, Kathleen M; Steffens, David C; Potter, Guy G

2016-10-01

Identify depression symptoms during active late-life depression (LLD) that predict conversion to dementia. The authors followed a cohort of 290 participants from the Neurocognitive Outcomes of Depression in the Elderly study. All participants were actively depressed and cognitively normal at enrollment. Depression symptom factors were derived from prior factor analysis: anhedonia and sadness, suicidality and guilt, appetite and weight loss, sleep disturbance, and anxiety and tension. Cox regression analysis modeled time to Alzheimer disease (AD) and non-AD dementia onset on depression symptom factors, along with age, education, sex, and race. Significant dementia predictors were tested for interaction with age at depression onset. Higher scores on the appetite and weight loss symptom factor were associated with an increased hazard of both AD and non-AD dementia. This factor was moderated by age at first depression onset, such that higher scores were associated with higher risk of non-AD dementia when depression first occurred earlier in life. Other depression symptom factors and overall depression severity were not related to risk of AD or non-AD dementia. Results suggest greater appetite/weight loss symptoms in active episodes of LLD are associated with increased likelihood of AD and non-AD dementia, but possibly via different pathways moderated by age at first depression onset. Results may help clinicians identify individuals with LLD at higher risk of developing AD and non-AD dementia and design interventions that reduce this risk. Copyright © 2016. Published by Elsevier Inc.

Convergence in Reports of Adolescents' Psychopathology: A Focus on Disorganized Attachment and Reflective Functioning.

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Borelli, Jessica L; Palmer, Alexandra; Vanwoerden, Salome; Sharp, Carla

2017-12-13

Although convergence in parent-youth reports of adolescent psychopathology is critical for treatment planning, research documents a pervasive lack of agreement in ratings of adolescents' symptoms. Attachment insecurity (particularly disorganized attachment) and impoverished reflective functioning (RF) are 2 theoretically implicated predictors of low convergence that have not been examined in the literature. In a cross-sectional investigation of adolescents receiving inpatient psychiatric treatment, we examined whether disorganized attachment and low (adolescent and parent) RF were associated with patterns of convergence in adolescent internalizing and externalizing symptoms. Compared with organized adolescents, disorganized adolescents had lower parent-youth convergence in reports of their internalizing symptoms and higher convergence in reports of their externalizing symptoms; low adolescent self-focused RF was associated with low convergence in parent-adolescent reports of internalizing symptoms, whereas low adolescent global RF was associated with high convergence in parent-adolescent reports of externalizing symptoms. Among adolescents receiving inpatient psychiatric treatment, disorganized attachment and lower RF were associated with weaker internalizing symptom convergence and greater externalizing symptom convergence, which if replicated, could inform assessment strategies and treatment planning in this setting.

Loneliness Mediates the Relationship Between Pain During Intercourse and Depressive Symptoms Among Young Women.

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Stout, Madison E; Meints, Samantha M; Hirsh, Adam T

2018-03-06

Previous research suggests that women who experience pain during intercourse also experience higher rates of depressive symptoms. Loneliness might be one factor that contributes to this relationship. We hypothesized that women who experience more severe and interfering pain during intercourse would report higher rates of loneliness and higher rates of depressive symptoms. Further, we hypothesized that loneliness would mediate the relationship between pain during intercourse and depressive symptoms. A total of 104 female participants (85.6% white, 74.03% partnered, 20.9 [3.01] years old) completed an online survey including demographic information, PROMIS Vaginal Discomfort Measure, PROMIS Depression Measure, and Revised UCLA Loneliness Scale. Pearson correlations and bootstrapped mediation analysis examined the relationships among pain during intercourse, loneliness, and depressive symptoms. Pain during intercourse, loneliness, and depressive symptoms were all significantly correlated (p pain during intercourse and depressive symptoms (indirect effect = 0.077; 95% CI 0.05-0.19). After accounting for loneliness, pain during intercourse was not significantly related to depressive symptoms, suggesting that loneliness fully mediated the relationship between pain during intercourse and depressive symptoms. These findings are consistent with previous studies highlighting that pain during intercourse is related to depressive symptoms. The current study adds to that literature and suggests that more frequent and severe pain during intercourse leads to more loneliness, which then leads to increased depressive symptoms. This line of work has important implications for treating women who experience depressive symptoms and pain during intercourse.

Strategic Enrollment Management: Transforming Higher Education

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Bontrager, Bob; Ingersoll, Doris; Ingersoll, Ronald

2012-01-01

As external forces demand change in the delivery of postsecondary education and institutions seek to take advantage of new opportunities, the potential for achieving higher levels of student and institutional success is vast. New technologies, communication tools, data use, and organizational constructs present key factors in improving the…

Warm Parenting and Effortful Control in Toddlerhood: Independent and Interactive Predictors of School-Age Externalizing Behavior.

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Reuben, Julia D; Shaw, Daniel S; Neiderhiser, Jenae M; Natsuaki, Misaki N; Reiss, David; Leve, Leslie D

2016-08-01

Externalizing symptoms, such as aggression, impulsivity, and inattention, represent the most common forms of childhood maladjustment (Campbell et al. Development and Psychopathology, 12, 467-488, 2000). Several dimensions of parenting behavior, including overreactive and warm parenting, have been linked to children's conduct problems. However, the majority of these studies involve biologically-related family members, thereby limiting understanding of the role of genetic and/or environmental underpinnings of parenting on child psychopathology. This study extends previous research by exploring associations between overreactive and warm parenting during toddlerhood and school-age externalizing problems, as well as the potential moderating effects of child effortful control (EC) on such associations using a longitudinal adoption design. The sample consisted of 225 adoption-linked families (adoptive parents, adopted child [124 male and 101 female] and birth parent[s]), thereby allowing for a more precise estimate of environmental influences on the association between parenting and child externalizing problems. Adoptive mothers' warm parenting at 27 months predicted lower levels of child externalizing problems at ages 6 and 7. Child EC moderated this association in relation to teacher reports of school-age externalizing problems. Findings corroborate prior research with biological families that was not designed to unpack genetic and environmental influences on associations between parenting and child externalizing problems during childhood, highlighting the important role of parental warmth as an environmental influence.

Indoor Thermal Factors and Symptoms in Office Workers: Findings from the U.S. EPA BASE Study

Energy Technology Data Exchange (ETDEWEB)

Mendell, Mark; Mirer, Anna

2008-06-01

Some prior research in office buildings has associated higher indoor temperatures even within the recommended thermal comfort range with increased worker symptoms. We reexamined this relationship in data from 95 office buildings in the U.S. Environmental Protection Agency's Building Assessment Survey and Evaluation (BASE) Study. We investigated relationships between building-related symptoms and thermal metrics constructed from real-time measurements. We estimated odds ratios (ORs) and 95percent confidence intervals in adjusted logistic regression models with general estimating equations, overall and by season. Winter indoor temperatures spanned the recommended winter comfort range; summer temperatures were mostly colder than the recommended summer range. Increasing indoor temperatures, overall, were associated with increases in few symptoms. Higher winter indoor temperatures, however, were associated with increases in all symptoms analyzed. Higher summer temperatures, above 23oC, were associated with decreases in most symptoms. Humidity ratio, a metric of absolute humidity, showed few clear associations. Thus, increased symptoms with higher temperatures within the thermal comfort range were found only in winter. In summer, buildings were overcooled, and only the higher observed temperatures were within the comfort range; these were associated with decreased symptoms. Confirmation of these findings would suggest that thermal management guidelines consider health effects as well as comfort.

Overweight children report qualitatively distinct asthma symptoms: analysis of validated symptom measures.

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Lang, Jason E; Hossain, Md Jobayer; Lima, John J

2015-04-01

Past studies of asthma in overweight/obese children have been inconsistent. The reason overweight/obese children commonly report worse asthma control remains unclear. To determine qualitative differences in symptoms between lean and overweight/obese children with early-onset, atopic asthma. We conducted a cross-sectional analytic study of lean (20% to 65% body mass index) and overweight/obese (≥85% body mass index) 10- to 17-year-old children with persistent, early-onset asthma. Participants completed 2 to 3 visits to provide a complete history, qualitative and quantitative asthma symptom characterization, and lung function testing. We determined associations between weight status and symptoms using multivariable linear and logistic regression methods. Overweight/obese and lean asthmatic children displayed similar lung function. Despite lower fraction of exhaled nitric oxide (30.0 vs 62.6 ppb; P = .037) and reduced methacholine responsiveness (PC20FEV1 1.87 vs 0.45 mg/mL; P overweight/obese children reported more than thrice frequent rescue treatments (3.7 vs 1.1 treatments/wk; P = .0002) than did lean children. Weight status affected the child's primary symptom reported with loss of asthma control (Fisher exact test; P = .003); overweight/obese children more often reported shortness of breath (odds ratio = 11.8; 95% CI, 1.41-98.7) and less often reported cough (odds ratio = 0.26; 95% CI, 0.08-0.82). Gastroesophageal reflux scores were higher in overweight/obese children (9.6 vs 23.2; P = .003) and appear to mediate overweight/obesity-related asthma symptoms. Overweight/obese children with early-onset asthma display poorer asthma control and a distinct pattern of symptoms. Greater shortness of breath and β-agonist use appears to be partially mediated via esophageal reflux symptoms. Overweight children with asthma may falsely attribute exertional dyspnea and esophageal reflux to asthma, leading to excess rescue medication use. Copyright © 2014 American

[External cephalic version].

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Navarro-Santana, B; Duarez-Coronado, M; Plaza-Arranz, J

2016-08-01

To analyze the rate of successful external cephalic versions in our center and caesarean sections that would be avoided with the use of external cephalic versions. From January 2012 to March 2016 external cephalic versions carried out at our center, which were a total of 52. We collected data about female age, gestational age at the time of the external cephalic version, maternal body mass index (BMI), fetal variety and situation, fetal weight, parity, location of the placenta, amniotic fluid index (ILA), tocolysis, analgesia, and newborn weight at birth, minor adverse effects (dizziness, hypotension and maternal pain) and major adverse effects (tachycardia, bradycardia, decelerations and emergency cesarean section). 45% of the versions were unsuccessful and 55% were successful. The percentage of successful vaginal delivery in versions was 84% (4% were instrumental) and 15% of caesarean sections. With respect to the variables studied, only significant differences in birth weight were found; suggesting that birth weight it is related to the outcome of external cephalic version. Probably we did not find significant differences due to the number of patients studied. For women with breech presentation, we recommend external cephalic version before the expectant management or performing a cesarean section. The external cephalic version increases the proportion of fetuses in cephalic presentation and also decreases the rate of caesarean sections.

Externally guided target for inertial fusion

International Nuclear Information System (INIS)

Martinez-Val, J.M.; Piera, M.

1996-01-01

A totally new concept is proposed to reach fusion conditions by externally guided inertial confinement. The acceleration and compression of the fuel is guided by a cannon-like external duct with a conical section ending in a small-size cavity around the central point of the tube. The fuel pellets coming from each cannon mouth collide in the central cavity where the implosion and final compression of the fuel take place. Both the tube material density and its areal density must be much higher than the initial density and areal density of the fuel. The external tube will explode into pieces as a consequence of the inner pressures achieved after the fuel central collision. If the collision is suitably driven, a fusion burst can take place before the tube disassembly. because of the features of the central collision needed to trigger ignition, this concept could be considered as tamped impact fusion. Both the fusion products and the debris from the guide tube are caught by a liquid-lithium curtain surrounding the target. Only two driving beams are necessary. The system can be applied to any type of driver and could use a solid pellet at room temperature as the initial target. 54 refs., 24 figs., 1 tab

Comorbid behavioural problems in Tourette's syndrome are positively correlated with the severity of tic symptoms.

Science.gov (United States)

Zhu, Yan; Leung, Kai Man; Liu, Po-zi; Zhou, Ming; Su, Lin-yan

2006-01-01

We studied the comorbid behavioural and mood problems in children with non-psychiatric Tourette's syndrome (TS) and their relationship with severity of tic disorder. Sixty-nine TS children and 69 healthy controls were assessed by Child Behavior Checklist (CBCL) and Yale Global Tic Severity Scale (YGTSS). The relationships between behavioural problems and severity of tic symptoms were analysed statistically by comparison, correlation and multiple linear regression. Tourette's syndrome patients scored significantly lower (ptic symptoms is positively correlated with the severity of overall impairment in school and social competence. When the behavioural and mood problems commonly associated with TS were studied in detail, we found that delinquent behaviour, thought problems, attention problems, aggressive behaviour and externalizing are positively correlated with severity of tic symptoms. The findings indicated that children with TS-only also had a broad range of behavioural problems, and some of these were related to the severity of tic symptoms.

Stakeholders and quality assurance in higher education

NARCIS (Netherlands)

Leisyte, Liudvika; Westerheijden, Donald F.; Eggins, Heather

2014-01-01

The various changes in post-bureaucratic organising, which are moving towards network approaches, coupled with the managerial agenda of corporate governance, have redefined the roles of various internal and external stakeholders in the governance of higher education institutions (Leisyte and Dee,

Examining Alternative Explanations of the Covariation of ADHD and Anxiety Symptoms in Children: A Community Study

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Baldwin, Jennifer S.; Dadds, Mark R.

2008-01-01

Attention-deficit hyperactivity disorder (ADHD) is comorbid with a range of other disorders, including anxiety disorders. The aim was to examine different explanations for the covariation of these symptom domains in children according to the framework provided by (Lilienfeld, S. O. Comorbidity between and within childhood externalizing and…

Symptom Experience Associated With Immunosuppressive Medications in Chinese Kidney Transplant Recipients.

Science.gov (United States)

Teng, Sha; Zhang, Shuping; Zhang, Wenxin; Lin, Xiaohong; Shang, Yabin; Peng, Xiao; Liu, Hongxia

2015-09-01

Kidney transplant recipients require lifelong treatment with immunosuppressive medications to avoid graft rejection and graft loss. Symptoms experienced may influence recipients' perceived quality of life and medication adherence. The purpose of this study was to evaluate the symptom experience associated with immunosuppressive medications in adult kidney transplant recipients and to explore the association between the symptom experience and adherence to immunosuppressive medications. A cross-sectional design was used. The study was conducted in a general hospital in China from October 2013 to September 2014. A total of 231 recipients with a follow-up of at least 1 year after kidney transplantation were included. Symptom experience associated with immunosuppressive medications was measured by the 13-item Symptom Experience of Immunosuppressive-related Side Effects Scale. Self-reported adherence to immunosuppressive medications was assessed using the Adherence with Immunosuppressive Medication Scale. Ridit analysis was used to rank symptom distress items. A proportion of 60.6% of recipients were male; the time after kidney transplantation was arbitrarily divided into a short-term cohort (1-4 years) and a long-term cohort (4-16 years) according to the median duration of follow-up (4 years). High blood pressure, hair loss, and tiredness were the three most distressing symptoms over all items of the whole sample. High blood pressure was the most distressing symptom for the 1- to 4-year cohort and the 4- to 16-year cohort. For men high blood pressure was the most distressing symptom, whereas for women hair loss was the most distressing symptom. Recipients in the 4- to 16-year cohort perceived a higher level of symptom distress compared with those in the 1- to 4-year cohort, especially in excess hair growth and difficulty sleeping. A negative relationship was found between symptom distress and adherence to immunosuppressive medications (r = -.541, p = .000). Recipients

Thought-action fusion in individuals with OCD symptoms.

Science.gov (United States)

Amir, N; Freshman, M; Ramsey, B; Neary, E; Brigidi, B

2001-07-01

Rachman (Rachman, S. (1993). Obsessions, responsibility, and guilt. Behaviour Research and Therapy, 31, 149-154) suggested that patients with OCD may interpret thoughts as having special importance, thus experiencing thought-action fusion (TAF). Shafran, Thordarson and Rachman (Shafran, R., Thordarson, D. S. & Rachman, S. (1996). Thought-action fusion in obsessive compulsive disorder. Journal of Anxiety Disorders, 710, 379-391) developed a questionnaire (TAF) and found that obsessives scored higher than non-obsessives on the measure. In the current study, we modified the TAF to include a scale that assessed the "likelihood of events happening to others" as well as ratings of the responsibility and cost for having these thoughts. Replicating previous findings, we found that individuals with OC symptoms gave higher ratings to the likelihood of negative events happening as a result of their negative thoughts. Individuals with OC symptoms also rated the likelihood that they would prevent harm by their positive thoughts higher than did individuals without OC symptoms. These results suggest that the role of thought-action fusion in OCs may extend to exaggerated beliefs about thoughts regarding the reduction of harm.

Neurotherapy of Traumatic Brain Injury/Post-Traumatic Stress Symptoms in Vietnam Veterans.

Science.gov (United States)

Nelson, David V; Esty, Mary Lee

2015-10-01

Previous report suggested the beneficial effects of an adaptation of the Flexyx Neurotherapy System (FNS) for the amelioration of mixed traumatic brain injury/post-traumatic stress symptoms in veterans of the Afghanistan and Iraq wars. As a novel variant of electroencephalograph biofeedback, FNS falls within the bioenergy domain of complementary and alternative medicine. Rather than learning voluntary control over the production/inhibition of brain wave patterns, FNS involves offsetting stimulation of brain wave activity by means of an external energy source, specifically, the conduction of electromagnetic energy stimulation via the connecting electroencephalograph cables. Essentially, these procedures subliminally induce strategic distortion of ongoing brain wave activity to presumably facilitate resetting of more adaptive patterns of activity. Reported herein are two cases of Vietnam veterans with mixed traumatic brain injury/post-traumatic stress symptoms, each treated with FNS for 25 sessions. Comparisons of pre- and post-treatment questionnaire assessments revealed notable decreases for all symptoms, suggesting improvements across the broad domains of cognition, pain, sleep, fatigue, and mood/emotion, including post-traumatic stress symptoms, as well as for overall activity levels. Findings suggest FNS treatment may be of potential benefit for the partial amelioration of symptoms, even in some individuals for whom symptoms have been present for decades. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

The Influence of Environmental Consequences and Internalizing Symptoms on Children's Tic Severity.

Science.gov (United States)

Eaton, Cyd K; Jones, Anna M; Gutierrez-Colina, Ana M; Ivey, Emily K; Carlson, Olivia; Melville, Lauren; Kardon, Patricia; Blount, Ronald L

2017-04-01

Although there is evidence that environmental consequences for displaying tics and internalizing symptoms are related to tic severity in children with TS, less is known about the inter-relationships of these variables or how these factors jointly contribute to tic severity. This study included 45 children with Tourette syndrome. Caregivers reported on children's environmental consequences for displaying tics, internalizing symptoms, and tic severity. Results indicated that children with higher levels of internalizing symptoms experienced significantly more environmental consequences for displaying tics. Children with higher levels of separation anxiety symptoms demonstrated significantly greater tic severity. Environmental consequences for displaying tics accounted for significantly more variance in predicting tic severity than anxiety symptoms. This preliminary evidence suggests that environmental consequences for displaying tics, such as receiving accommodations or attention from others, have a greater influence on children's tic severity than emotional factors.

Aortic pseudoaneurysm detected on external jugular venous distention following a Bentall procedure 10 years previously.

Science.gov (United States)

Fukunaga, Naoto; Shomura, Yu; Nasu, Michihiro; Okada, Yukikatsu

2010-11-01

An asymptomatic 49-year-old woman was admitted for the purpose of surgery for aortic pseudoaneurysm. She had Marfan syndrome and had undergone an emergent Bentall procedure 10 years previously. About six months previously, she could palpate distended bilateral external jugular veins, which became distended only in a supine position and without any other symptoms. Enhanced computed tomography revealed an aortic pseudoaneurysm originating from a previous distal anastomosis site. During induction of general anesthesia in a supine position, bilateral external jugular venous distention was remarkable. Immediately after a successful operation, distention completely resolved. The present case emphasizes the importance of physical examination leading to a diagnosis of asymptomatic life-threatening diseases in patients with a history of previous aortic surgery.

Metabolic syndrome is associated with muscle symptoms among statin users.

Science.gov (United States)

Brinton, Eliot A; Maki, Kevin C; Jacobson, Terry A; Sponseller, Craig A; Cohen, Jerome D

2016-01-01

Muscle symptoms have been associated with statin use, but the relationship of statin-associated muscle symptoms with metabolic syndrome (MS) has not been reported previously. To evaluate the relationships between MS and its individual components with statin-associated muscle symptoms. Data were analyzed from the Understanding Statin Use in America and Gaps in Education (USAGE) study. Modified criteria to define the MS were used based on self-reported survey data. Among USAGE subjects, the MS was present in 1364 of 3992 men (34.2%) and in 1716 women of 6149 women (27.9%). Subjects with the MS were 19% more likely (P = .0002) to report new or worsening muscle symptoms while on a statin. Three MS criteria-increased BMI, elevated triglycerides (TG), and low high-density lipoprotein cholesterol (HDL-C)-were associated with increased odds of muscle symptoms, by 18%, 32%, and 28%, respectively (all P statin due to muscle symptoms (13% higher, P = .043). Among criteria for the MS, elevated TG (38% higher odds, P statin discontinuation, whereas hypertension (13% lower odds, P = .019) and diabetes mellitus (12% lower odds, P = .036) were inversely associated. USAGE participants with MS were more likely to report experiencing muscle symptoms while taking a statin and to have discontinued a statin due to muscle symptoms. This appears to be attributable mainly to associations of muscle symptoms with elevated TG and low HDL-C levels. Additional research is warranted to confirm and further investigate these associations. Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.

The scars of childhood adversity: minor stress sensitivity and depressive symptoms in remitted recurrently depressed adult patients.

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Gemma Kok

Full Text Available Childhood adversity may lead to depressive relapse through its long-lasting influence on stress sensitivity. In line with the stress sensitization hypothesis, minor (daily stress is associated with depressive relapse. Therefore, we examine the impact of childhood adversity on daily stress and its predictive value on prospectively assessed depressive symptoms in recurrently depressed patients.Daily stress was assessed in recurrently depressed adult patients, enrolled into two randomized trials while remitted. The reported intensity and frequency of dependent and independent daily stress was assessed at baseline. Independent stress is externally generated, for example an accident happening to a friend, while dependent stress is internally generated, for example getting into a fight with a neighbor. Hierarchical regression analyses were performed with childhood adversity, independent and dependent daily stress as predictor variables of prospectively measured depressive symptoms after three months of follow-up (n = 138.We found that childhood adversity was not significantly associated with a higher frequency and intensity of daily stress. The intensity of both independent and dependent daily stress was predictive of depressive symptom levels at follow-up (unadjusted models respectively: B = 0.47, t = 2.05, p = 0.041, 95% CI = 0.02-0.92; B = 0.29, t = 2.20, p = 0.028, 95% CI = 0.03-0.55. No associations were found between childhood adversity and depressive symptoms at follow-up.No evidence was found supporting stress sensitization due to the experience of childhood adversity in this recurrently depressed but remitted patient group. Nevertheless, our research indicates that daily stress might be a target for preventive treatment.Trial A: Nederlands Trial Register NTR1907 Trial B: Nederlands Trial Register NTR2503.

External radiation surveillance

Energy Technology Data Exchange (ETDEWEB)

Antonio, E.J.

1995-06-01

This section of the 1994 Hanford Site Environmental Report describes how external radiation was measured, how surveys were performed, and the results of these measurements and surveys. External radiation exposure rates were measured at locations on and off the Hanford Site using thermoluminescent dosimeters (TLD). External radiation and contamination surveys were also performed with portable radiation survey instruments at locations on and around the Hanford Site.

External radiation surveillance

International Nuclear Information System (INIS)

Antonio, E.J.

1995-01-01

This section of the 1994 Hanford Site Environmental Report describes how external radiation was measured, how surveys were performed, and the results of these measurements and surveys. External radiation exposure rates were measured at locations on and off the Hanford Site using thermoluminescent dosimeters (TLD). External radiation and contamination surveys were also performed with portable radiation survey instruments at locations on and around the Hanford Site

The role of bullying in depressive symptoms from adolescence to emerging adulthood: A growth mixture model.

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Hill, Ryan M; Mellick, William; Temple, Jeff R; Sharp, Carla

2017-01-01

The present study sought to identify trajectories of depressive symptoms in adolescence and emerging adulthood using a school-based sample of adolescents assessed over a five-year period. The study also examined whether bully and cyberbully victimization and perpetration significantly predicted depressive symptom trajectories. Data from a sample of 1042 high school students were examined. The sample had a mean age of 15.09 years (SD=.79), was 56.0% female, and was racially diverse: 31.4% Hispanic, 29.4% White, and 27.9% African American. Data were examined using growth mixture modeling. Four depressive symptoms trajectories were identified, including those with a mild trajectory of depressive symptoms, an increasing trajectory of depressive symptoms, an elevated trajectory of depressive symptoms, and a decreasing trajectory of depressive symptoms. Results indicated that bully victimization and cyberbully victimization differentially predicted depressive symptoms trajectories across adolescence, though bully and cyberbully perpetration did not. Limitations include reliance on self-reports of bully perpetration and a limited consideration of external factors that may impact the course of depression. These findings may inform school personnel in identifying students' likely trajectory of depressive symptoms and determining where depression prevention and treatment services may be needed. Copyright © 2016 Elsevier B.V. All rights reserved.

Externalizing problems, attention regulation, and household chaos: A longitudinal behavioral genetic study

Science.gov (United States)

Wang, Zhe; Deater-Deckard, Kirby; Petrill, Stephen A.; Thompson, Lee A.

2015-01-01

Previous research has documented a robust link between difficulties in self-regulation and development of externalizing problems (i.e., aggression and delinquency). In the current study, we examined the longitudinal additive and interactive genetic and environmental covariation underlying this well-established link using a twin design. The sample included 131 pairs of monozygotic twins and 173 pairs of same-sex dizygotic twins who participated in three waves of annual assessment. Mothers and fathers provided reports of externalizing problems. Teacher report and observer rating were used to assess twin’s attention regulation. The etiology underlying the link between externalizing problems and attention regulation shifted from a common genetic mechanism to a common environmental mechanism in the transition across middle childhood. Household chaos moderated the genetic variance of and covariance between externalizing problems and attention regulation. The genetic influence on individual differences in both externalizing problems and attention regulation was stronger in more chaotic household. However, higher levels of household chaos attenuated the genetic link between externalizing problems and attention regulation. PMID:22781853

Acculturation and Depressive Symptoms among Turkish Immigrants in Germany

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